Power of Attorney for Health Care Will to Live Form - Maine

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GENERAL PRESUMPTION FOR LIFE
I direct my health care provider(s) and health care attorney in fact(s) to make health care
decisions consistent with my general desire for the use of medical treatment that would preserve
my life, as well as for the use of medical treatment that can cure, improve, reduce or prevent
deterioration in, any physical or mental condition.
Food and water are not medical treatment, but basic necessities. I direct my health care
provider(s) and health care attorney in fact to provide me with food and fluids, orally,
intravenously, by tube, or by other means to the full extent necessary both to preserve my life
and to assure me the optimal health possible.
I direct that medication to alleviate my pain be provided, as long as the medication is not used in
order to cause my death.
I direct that the following be provided:
C the administration of medication;
C cardiopulmonary resuscitation (CPR); and
C the performance of all other medical procedures, techniques, and technologies,
including surgery,
–all to the full extent necessary to correct, reverse, or alleviate life-threatening or health
impairing conditions or complications arising from those conditions.
I also direct that I be provided basic nursing care and procedures to provide comfort care.
I reject, however, any treatments that use an unborn or newborn child, or any tissue or organ of
an unborn or newborn child, who has been subject to an induced abortion. This rejection does
not apply to the use of tissues or organs obtained in the course of the removal of an ectopic
pregnancy.
I also reject any treatments that use an organ or tissue of another person obtained in a manner
that causes, contributes to, or hastens that person’s death.
I request and direct that medical treatment and care be provided to me to preserve my life
without discrimination based on my age or physical or mental disability or the “quality” of my
life. I reject any action or omission that is intended to cause or hasten my death.
I direct my health care provider(s) and health care attorney in fact to follow the policy above,
even if I am judged to be incompetent.
During the time I am incompetent, my attorney in fact, as named below, is authorized to make
medical decisions on my behalf, consistent with the above policy, after consultation with my
health care provider(s), utilizing the most current diagnoses and/or prognosis of my medical
condition, in the following situations with the written special instructions.
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Power of Attorney for Health Care Will to Live Form - Maine PDF

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