Maine Living Will

This document declares the healthcare preferences and end-of-life decisions of [Your Name], hereafter referred to as "the Declarant," and becomes effective if the Declarant becomes incapacitated and unable to communicate their wishes.

I. Declaration

I, [Your Name], resident in [Your Address], being of sound mind, do hereby willfully and voluntarily declare my desire that my dying shall not be artificially prolonged under the circumstances set forth below, and I affirm this declaration reflects my firm and settled commitment to decline life-sustaining treatment under these circumstances.

II. Effective Date

This Living Will shall become effective upon the Declarant’s inability to communicate healthcare decisions due to medical incapacity, as determined by a licensed physician.

III. Healthcare Directives

My healthcare preferences, to be followed by any physician, healthcare provider, or individual appointed to make decisions on my behalf, are as follows:

3.1 Life-Sustaining Treatment

If I am in a terminal condition, I [do/do not] want life-sustaining treatment to be provided or continued. This includes treatments that could keep me alive but do not cure me.

3.2 Artificial Nutrition and Hydration

I [do/do not] want artificial nutrition (feeding tube) and hydration (IV fluids) if I am unable to eat or drink on my own.

3.3 Pain and Comfort Measures

Regardless of my other directives, I want measures taken to keep me comfortable and to relieve pain, including any pain-relieving drugs or other measures.

IV. Preferences in Other Medical Conditions

In any situation where I am unable to communicate my preferences, such as irreversible coma or persistent vegetative state:

I [do/do not] want my life to be prolonged through medical interventions.
I [do/do not] want resuscitation if my heart and/or breathing stops.

V. Healthcare Agent

I designate the following individual as my Healthcare Agent, who is authorized to make healthcare decisions on my behalf, under my wishes and best interests, and according to this document when I am unable to make my decisions known:

Name: [Healthcare Agent Name]
Address: [Healthcare Agent Address]
Phone Number: [Healthcare Phone Number]

VI. Signature and Witnesses

I affirm that this Living Will expresses my desires regarding medical treatment and end-of-life care.

[Your Name]

[Date Signed]

Witness 1

Name: [Witness 1 Name]

Address: [Witness 1 Address]

Date: [Date Signed]

Witness 2

Name: [Witness 1 Name]

Address: [Witness 1 Address]

Date: [Date Signed]

VIII. Notary Acknowledgment

County of [County Name], State of Maine

On this [Date], before me, [Notary's Name], a notary public in and for the said state, personally appeared [Your Name], known to me to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed the same as his/her free act and deed.

Witness my hand and official seal.

Notary Public: [Notary's Name]

My Commission Expires: [Expiration Date]