Life Sustaining Statute, Nevada

Directive to Physicians as Provided by Nevada Revised Statutes, Section 449.610
DIRECTIVE TO PHYSICIANS

Date __________________

I, _______________, being of sound mind, intentionally and voluntarily declare:
1. If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two physicians, and where the application of life-sustaining procedures would serve only to artificially prolong the moment of my death and where my physician determines that my death is imminent whether or not life-sustaining procedures are utilized, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally,
2. It is my intention that this directive shall be honored by my family and attending physician as the final expression of my legal right to refuse medical or surgical treatment and accept the consequences from such refusal.
3. If I have been diagnosed as pregnant and that fact is known to my physician, this directive shall have no force or effect during the course of my pregnancy. I understand the full import of this directive and I am emotionally and mentally competent to execute it.

Signed _________________________________________________

STATE OF _______
COUNTY OF __________

Dated: _________________________

Then and there personally appeared the within named ________________________________ and __________________________, who, being duly sworn, depose and say: That they witnessed the execution of the within Directive to Physicians of the within named _______________, that said declarant subscribed said Directive to Physicians and declared the same to be his Directive to Physicians in their presence, that they thereafter subscribed the same as witnesses in the presence of said declarant and in the presence of each other and at the request of said declarant; that the said declarant at the time of the execution of said Directive
to Physicians appeared to them to be of full age and of sound mind and memory, and that they make this affidavit at the request of said declarant.

________________________________________
Witness
________________________________________
Witness

Subscribed to and sworn to before me this ________ day of _________, 20_____.

_____________________________________________
Notary Public

Directive to Physicians as Provided by Nevada Revised Statutes, Section 449.610
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. This simple Life Sustaining Declaration is valid in Nevada. Check with a local hospital or doctor’s office, as well as with an experienced medical attorney, to assure yourself of its compliance with current statute (s) in your state.

1. Make multiple copies. Give one to your doctor (s), the local hospital, and have others available through your attorney and family. Remember, these kinds of documents are needed in emergency situations at worst and under stressful circumstances at best. So be sure they are available to the appropriate people easily, when needed.

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