Living Will (Advance Healthcare Directive)

LIVING WILL (ADVANCE HEALTHCARE DIRECTIVE) OF maker_name

Made on document_date at place_of_execution

I, maker_name, son/daughter of maker_father, aged about maker_age years, resident of maker_address, holder of CNIC No. maker_cnic, being of sound mind and full legal capacity, do hereby make this Advance Healthcare Directive ("Living Will") to express my preferences regarding medical treatment in the event that I am unable to communicate my wishes due to incapacity, terminal illness, or unconsciousness.

DECLARATIONS AND DIRECTIVES

1. CAPACITY: I declare that, at the time of executing this document, I am in sound mental health, of full age and capacity, and I am acting voluntarily without any coercion or undue influence. I have considered carefully the choices and consequences set out below.

2. APPOINTMENT OF HEALTHCARE PROXY: I hereby appoint healthcare_proxy_name, son/daughter of proxy_father, resident of proxy_address, CNIC No. proxy_cnic, as my healthcare proxy / agent, with authority to make medical decisions on my behalf in accordance with this Living Will, in the event I am unable to do so. The alternate proxy, if the first proxy is unable or unwilling to act, shall be alternate_proxy_name.

3. PREFERENCES REGARDING LIFE-SUSTAINING TREATMENT: In the event that I am suffering from a terminal condition, am in a persistent vegetative state, or am suffering from an irreversible condition with no reasonable prospect of recovery, certified by two qualified medical practitioners, I direct as follows: (a) life_sustaining_preference (e.g., I do / do not wish to receive cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, dialysis); (b) I do / do not wish to receive comfort care and pain management at all times consistent with my dignity.

4. PREFERENCES REGARDING ORGAN AND TISSUE DONATION: Upon my death, I organ_donation_preference (do / do not wish to donate my organs and tissues for transplantation, scientific research, and educational purposes). My specific preferences regarding which organs / tissues to donate are: organ_specifics.

5. RELIGIOUS AND CULTURAL CONSIDERATIONS: I direct that all medical care provided to me be consistent with my religious faith of religion and cultural values, including specific_religious_directives (e.g., observance of halal medication, modesty in care, presence of family during last rites, performance of last rites by clerics).

6. PAIN MANAGEMENT: I direct that I be provided with reasonable pain management, including the use of opioids and palliative sedation as may be necessary to relieve suffering, even if such treatment may have the secondary effect of shortening my life.

7. NUTRITION AND HYDRATION: I direct that artificial nutrition and hydration nutrition_hydration_preference (be provided / be withheld) in the circumstances described in Clause 3.

8. PALLIATIVE CARE PRINCIPLES: At all times during the care provided to me, I direct that the principles of palliative care be observed, with my comfort, dignity, and quality of life as paramount considerations, including the right to be free from unnecessary medical intervention.

9. ACCESS TO MEDICAL RECORDS: My healthcare proxy shall have full access to my medical records and shall be authorised to communicate with my medical care providers, hospitals, and insurance companies to give effect to this Living Will.

10. NOTIFICATION OF FAMILY: I direct that, in addition to my healthcare proxy, the following persons be notified of any serious medical condition: notification_list.

11. REVOCATION: This Living Will may be revoked or amended by me at any time during my legal capacity, by writing in similar form duly notarised. No oral statement or conduct shall amount to revocation save while I retain mental capacity.

12. EFFECT AND COMPLIANCE: I direct all medical practitioners, hospitals, and care facilities to give effect to this Living Will in accordance with their professional ethics and applicable law. Any practitioner unable in conscience to comply shall transfer my care to another practitioner who can give effect to my wishes.

13. NOTARISATION: I have signed this Living Will in the presence of the witnesses named below and have had it notarised, so that its authenticity may be readily established by my healthcare proxy and care providers.

SIGNED BY THE MAKER: _____________________________ maker_name, CNIC: maker_cnic WITNESSES: 1. witness_1_name, CNIC: witness_1_cnic 2. witness_2_name, CNIC: witness_2_cnic NOTARY PUBLIC: _____________________________ notary_details