If I have been declared terminally ill, I do not want chemo, radiation, heart-lung machine, dialysis, or respirator to prolong life. I only want to be made as comfortable as possible until the natural end of life: ie pain pills, sleeping pills, back rubs, etc.” I particularly do not want the following in any terminal circumstance: electric or mechanical resuscitation of my heart, nasal-gastric tube feeding when I am no longer able to swallow, uncomfortable diagnostic tests, mechanical respiration when my brain can no longer sustain my own breathing, blood or plasma transfusions.” If there is no reasonable hope for my recovery, I direct that I be allowed to die naturally; no long-term mechanical ventilation…any treatment that will not help me recover and will only prolong the dying process, including tubes in the [trachea], stomach, colon…” …do not tube feed if in a coma or persistent vegetative state, let me die naturally. I am not afraid of death; I do not want to be a burden to my family.” I do not want any treatment if it will not help me recover and will only prolong the dying process…I do not want tube feeding or CPR or long-term mechanical respiration that is not necessary to provide comfort or relief from pain…I do not want any artificially administered sustenance, tube feeding in particular.” I do not want extraordinary measures or other artificially life-sustaining procedures, such as mechanical respirators, intravenous feeding, and transfusions of blood; heart stimulation; and similar-like procedures if I have an incurable or terminal injury or illness from which there is no reasonable expectation of recovery. Similarly, if I am in a coma from which there is little or no chance of regaining consciousness, I do not want such procedures. I want no surgery, invasive measures, or tube feeding for a terminal condition.” I wish not to be put on a ventilator if it is known that my condition is terminal … no ventilator, no CPR, no blood transfusions.”
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