Louisiana Living Will

I. Introduction

This Living Will document is made on [Date] by and between [Your Name], residing at [Your Address], referred to as the "Declarant," of sound mind and legal capacity.

II. Declaration of Intent

I, [Your Name], being of sound mind, hereby declare this document to be my living will, expressing my desires and wishes regarding medical treatment and end-of-life decisions if I am unable to communicate my wishes directly.

III. Health Care Proxy

I appoint [Health Care Agent's Name], residing at [Agent's Address], as my Health Care Agent to make health care decisions on my behalf if I am unable to do so.

If my primary Health Care Agent is unable, unwilling, or unavailable to serve, then I appoint [Secondary Health Care Agent's Name], residing at [Agent's Address], as my alternate Health Care Agent.

IV. Directions Regarding Life-Sustaining Treatment

If I am unable to communicate my healthcare decisions, and I am in a medical condition specified below, I direct that:

If I am in a terminal condition, I request withholding or withdrawal of all treatments that would only prolong the dying process and request that life-sustaining measures be withheld or withdrawn.

If I am in a state of permanent unconsciousness, and there is no reasonable expectation of my recovery, life-sustaining measures should be withheld or withdrawn.

V. Additional Provisions and Instructions

Even if the choices are to withhold or withdraw treatment in other circumstances, I further specify the following:

Pain relief medication should always be provided as needed to ensure my comfort, even if it hastens my death.

I do not wish to receive artificial nutrition and hydration if the burdens of the treatment outweigh the expected benefits.

My healthcare agent shall have the authority to make decisions about autopsy, organ donation, and disposition of my body.

VI. Duration

This declaration remains valid and in force unless and until I revoke it.

VII. Signature and Witnesses

I sign this Living Will on [Date] in the presence of the following witnesses, who also sign in my presence.

Declarant

[Your Name]

Witness 1

Name: [Witness 1 Name]

Address: [Witness 1 Address]

Witness 2

Name: [Witness 2 Name]

Address: [Witness 2 Address]

VIII. Notary Acknowledgment

Parish of [Parish Name], State of Louisiana

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]