Homepage Free Living Will Form Attorney-Verified Living Will Template for New York

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New York Living Will Template

This Living Will is made in accordance with New York State law and outlines your wishes regarding medical treatment in situations where you may no longer be capable of making decisions for yourself.

Declaration of Wishes

I, [Your Full Name], residing at [Your Address], in the County of [Your County], State of New York, being of sound mind, make this Living Will to communicate my wishes concerning medical treatment in the event that I am unable to do so myself.

Definition of Terminal Condition

A terminal condition is defined as an incurable and irreversible condition that, without the provision of life-sustaining treatment, will result in death within a relatively short time frame. I understand this definition and wish to provide guidance to my healthcare providers in the event of such a condition.

Wishes Concerning Life-Sustaining Treatment

In the event that I have a terminal condition, I do not want the following treatments to be administered:

  • Cardiopulmonary resuscitation (CPR)
  • Mechanical ventilation
  • Dialysis
  • Artificial nutrition and hydration

If I cannot communicate and am diagnosed with a permanent unconscious condition or a severe and irreversible deterioration of my mental abilities, I wish to receive:

  • Palliative care to relieve pain and discomfort.
  • No measures that would prolong the dying process.

Appointment of Health Care Agent

I hereby appoint the following individual as my Health Care Agent, who will make healthcare decisions on my behalf if I am unable to do so:

[Agent's Full Name]
[Agent's Address]
[Agent's Phone Number]

Effect of this Living Will

This Living Will shall be effective when my attending physician determines that I am unable to make my own healthcare decisions.

Revocation of Previous Documents

This document revokes any previous Living Wills or advance directives I may have signed. This Living Will reflects my current wishes and may be revised or revoked by me at any time.

Signatures

In Witness Whereof, I have signed this Living Will on this [Date].

[Your Signature]
[Your Printed Name]

Witnesses

We, the undersigned witnesses, affirm that the individual who signed this Living Will is known to us and appears to be of sound mind, able to make this declaration.

[Witness 1 Full Name]
[Witness 1 Signature]
[Witness 1 Address]
[Date]

[Witness 2 Full Name]
[Witness 2 Signature]
[Witness 2 Address]
[Date]

Documents used along the form

A New York Living Will is an essential document that outlines a person's wishes regarding medical treatment in the event they become unable to communicate those wishes. However, it is often accompanied by other important forms and documents that work together to ensure a comprehensive approach to healthcare decisions. Below is a list of related documents that are commonly used alongside a Living Will.

  • Health Care Proxy: This document allows an individual to appoint someone they trust to make medical decisions on their behalf if they are unable to do so. The appointed person, known as the agent, can ensure that the individual's healthcare preferences are honored.
  • Durable Power of Attorney: This legal document grants someone the authority to make financial and legal decisions for another person. Unlike a standard power of attorney, this version remains effective even if the person becomes incapacitated.
  • Do Not Resuscitate (DNR) Order: A DNR order is a specific request not to have CPR performed if a person's heart stops or they stop breathing. This document is typically signed by a physician and is intended to honor the patient's wishes in emergency medical situations.
  • Physician Orders for Life-Sustaining Treatment (POLST): This form translates a patient's wishes regarding treatment into medical orders. It is especially useful for those with serious illnesses and ensures that healthcare providers follow the patient's preferences during emergencies.
  • Advance Directive: An advance directive is a broader term that encompasses both living wills and health care proxies. It provides guidance on a person's healthcare preferences and appoints a decision-maker if needed.
  • Organ Donation Consent: This document expresses an individual's wishes regarding organ donation after death. It can be included in a living will or created as a separate document to ensure that the person's wishes are known and respected.
  • Patient Advocate: A patient advocate is a person or organization that helps patients understand their rights and navigate the healthcare system. While not a formal document, having an advocate can be crucial for ensuring that healthcare preferences are communicated effectively.
  • Medical History Form: This form provides healthcare providers with essential information about a patient's medical background, including allergies, medications, and previous conditions. It aids in making informed decisions about treatment options.
  • Room Rental Agreement: This essential document outlines the terms of renting a room in New York, protecting both parties' rights. For further details, you can refer to the nypdfforms.com/room-rental-agreement-form.
  • Emergency Contact List: This list includes the names and contact information of individuals to be reached in case of a medical emergency. It is helpful for healthcare providers to have this information readily available.

Each of these documents plays a vital role in ensuring that a person's healthcare wishes are respected and followed. By preparing these forms, individuals can have peace of mind knowing that their preferences will be honored, even when they cannot voice them themselves.

Similar forms

  • Advance Directive: This document outlines an individual's preferences regarding medical treatment and interventions in situations where they cannot communicate their wishes. It serves a similar purpose to a Living Will but can also include health care power of attorney provisions.
  • Durable Power of Attorney for Health Care: This allows a person to appoint someone else to make medical decisions on their behalf. While a Living Will specifies treatment preferences, this document designates an individual to carry out those preferences.
  • Do Not Resuscitate (DNR) Order: A DNR order is a specific request not to receive CPR or other life-saving measures. Like a Living Will, it communicates a person's wishes regarding end-of-life care but focuses solely on resuscitation efforts.
  • Health Care Proxy: Similar to a durable power of attorney, a health care proxy designates someone to make medical decisions for an individual. It can work in conjunction with a Living Will to ensure that the appointed person understands the individual’s treatment preferences.
  • Durable Power of Attorney: This essential document grants someone the authority to make legal decisions on behalf of another, ensuring that preferences are honored. For more information, visit Durable Power of Attorney.
  • Physician Orders for Life-Sustaining Treatment (POLST): This document translates a patient's wishes regarding life-sustaining treatment into actionable medical orders. It is similar to a Living Will but is intended for use by emergency medical personnel and health care providers.
  • Do Not Intubate (DNI) Order: A DNI order specifies that a patient does not wish to be intubated if they are unable to breathe on their own. Like a Living Will, it expresses specific preferences regarding medical interventions.
  • Personal Health Care Plan: This document can outline an individual’s overall health care preferences and goals. While broader in scope than a Living Will, it shares the intent of guiding medical decisions based on the individual's values and wishes.
  • End-of-Life Care Plan: This plan details preferences for care during the final stages of life. It is similar to a Living Will in that it addresses specific wishes regarding treatment and comfort measures as life nears its end.

Misconceptions

Many people have misunderstandings about the New York Living Will form. Here are seven common misconceptions, along with clarifications for each.

  1. A Living Will is the same as a Last Will and Testament.

    A Living Will specifically addresses medical decisions and end-of-life care, while a Last Will and Testament deals with the distribution of assets after death.

  2. You must be terminally ill to create a Living Will.

    Anyone over the age of 18 can create a Living Will, regardless of their current health status. It’s a proactive way to express medical preferences.

  3. A Living Will is only for older adults.

    People of all ages can benefit from having a Living Will. Accidents and unexpected health issues can happen at any time.

  4. Your family will automatically know your wishes.

    Without a Living Will, family members may not be aware of your preferences. It’s essential to document your wishes clearly.

  5. A Living Will is legally binding in all states.

    While many states recognize Living Wills, each state has its own laws. A New York Living Will may not have the same effect in another state.

  6. You cannot change your Living Will once it’s created.

    You can modify or revoke your Living Will at any time, as long as you are mentally competent to do so.

  7. Your healthcare provider will always follow your Living Will.

    While healthcare providers are generally obligated to honor a Living Will, certain situations may arise where they cannot comply due to medical ethics or legal constraints.

Understanding New York Living Will

  1. What is a New York Living Will?

    A New York Living Will is a legal document that outlines your preferences regarding medical treatment in the event that you become unable to communicate your wishes. It specifically addresses situations where you may be terminally ill or in a persistent vegetative state.

  2. Who should have a Living Will?

    Anyone over the age of 18 should consider having a Living Will. This document is particularly important for individuals with serious health conditions, those undergoing major surgeries, or anyone who wants to ensure their medical preferences are known and respected.

  3. How do I create a Living Will in New York?

    To create a Living Will in New York, you can either use a template or consult with an attorney who specializes in estate planning. The document must clearly state your wishes regarding medical treatment and should be signed in the presence of at least two witnesses. It is also advisable to keep copies of the document in accessible locations and share them with your healthcare proxy.

  4. Can I change or revoke my Living Will?

    Yes, you can change or revoke your Living Will at any time, as long as you are of sound mind. To do this, simply create a new document that clearly states your updated wishes or destroy the original document. It is important to inform your healthcare proxy and any relevant medical professionals of these changes.

  5. What happens if I do not have a Living Will?

    If you do not have a Living Will, your medical treatment decisions may be made by your family members or healthcare providers, which may not align with your personal wishes. This can lead to confusion and potential conflict during difficult times. Having a Living Will ensures that your preferences are known and followed.

  6. Is a Living Will the same as a Health Care Proxy?

    No, a Living Will and a Health Care Proxy serve different purposes. A Living Will outlines your specific medical treatment preferences, while a Health Care Proxy designates a person to make healthcare decisions on your behalf if you are unable to do so. It is often advisable to have both documents in place to ensure comprehensive planning for your healthcare needs.