Revocation Of Life Sustaining Agreement
Revocation of Previous Living Will and Medical Care Restrictions
I, ________________, desire to make aware that after mature reflection, and, being aware of the right under the law to decline life- sustaining treatment, that I wish, should I ever be unable to make decisions for myself concerning my medical treatment that I receive life sustaining treatment even after a terminal diagnosis, even if the life prolonging treatment will delay the natural process of dying.
I have previously made a “living will” or other document expressing a desire contrary to that specified herein, and by this document I herewith revoke the same.
Dated: _________________________________________
________________________________________________
Declarant________________________________________________
Witness & Address________________________________________________
Witness & Address________________________________________________
Witness & AddressCity of residence: _______________
County of residence: _____________
State of residence: ______________
Social Security Number: __________Date: _________________
________________________________________________________________
Witness________________________________________________________________
Witness
STATE OF ________________________
COUNTY OF _______________________This day personally appeared before me, the undersigned authority, a Notary Public in and for ______________ County, ___________________________State, ______________________________ _______________________________(Witnesses) who, being first being duly sworn, say that they are the subscribing witnesses to the declaration of ________________, the Declarant, signed, sealed and published and declared the same as and for his declaration, in the presence of both these affiants; and that these affiants, at the request of said Declarant, in the presence of each other, and in the presence of said Declarant, all present at the same time, signed their names as attesting witnesses to said declaration.
Affiants further say that this affidavit is made at the request of ________________, Declarant, and in his presence, and that ________________ at the time the declaration was executed, in the opinion of the affiants, of sound mind and memory, and over the age of eighteen years.
Taken, subscribed and sworn to before me by _________________ (witness) and ____________________________ (witness) this _______ day of ____________________________, 20_____.My commission expires: __________________
Revocation of Previous Living Will and Medical Care Restrictions
Review ListThis review list is provided to inform you about this document in question and you in its preparation. Revocations are generally made because of a serious change in attitude. Therefore, you should be very careful to have your wishes implemented. Get three witnesses; have them notarized; get the documents in everyone’s hands that previously had one; and try to recover as many originals as you can, that you handed out previously, to avoid conflicting directions.
Frequently Asked Questions
What is a revocation of life sustaining agreement?
A revocation of life sustaining agreement is a legal document that allows an individual to revoke a previous living will or medical care restrictions. In the supplied article, the declarant states that after mature reflection and awareness of the right to decline life-sustaining treatment, they wish to receive life-sustaining treatment even after a terminal diagnosis. This document explicitly revokes any prior living will or other document expressing a contrary desire.
How do I revoke a living will?
To revoke a living will, you can use a document like the one in the article, which includes a statement of revocation and requires your signature, date, and witnesses. The article shows a form with fields for the declarant, witnesses, and residence information. By signing this document, you formally revoke any previous living will or medical care restrictions.
What does a revocation of life sustaining agreement include?
The revocation of life sustaining agreement includes a declaration of the person's desire to receive life-sustaining treatment even after a terminal diagnosis, and a statement revoking any previous living will or contrary document. It also includes spaces for the declarant's signature, date, witnesses with addresses, and residence details such as city, county, state, and Social Security Number. The form provided in the article serves as a template for this purpose.
Can I revoke a living will and request life-sustaining treatment?
Yes, the article indicates that an individual can revoke a living will and request life-sustaining treatment through a document like the one provided. The declarant expresses a wish to receive life-sustaining treatment even after a terminal diagnosis, and revokes any prior living will or document expressing a contrary desire. This is done after mature reflection and with awareness of the right to decline such treatment.
What is the purpose of revoking a living will?
The purpose of revoking a living will is to change one's previously expressed wishes regarding medical treatment. In the article, the declarant wishes to receive life-sustaining treatment even after a terminal diagnosis, contrary to what a previous living will might have stated. By revoking the prior document, the declarant ensures that their current wishes are legally recognized.
Who can witness a revocation of life sustaining agreement?
The article does not specify who can witness the document, but it provides fields for witnesses and their addresses. Typically, witnesses must be adults who are not related to the declarant and not named in the document, but this is not stated in the article. The form includes three witness lines, indicating that multiple witnesses may be required.
Is a revocation of life sustaining agreement legally binding?
The article does not explicitly state whether the document is legally binding, but it is presented as a formal legal document with spaces for signatures, witnesses, and personal information. It is implied that when properly executed, it serves to revoke previous directives. For legal validity, it should comply with state laws, which are not detailed in the article.
What information is needed to complete a revocation of life sustaining agreement?
To complete the revocation of life sustaining agreement, you need to provide your name, date, signature, and the signatures and addresses of witnesses. Additionally, you must include your city, county, and state of residence, as well as your Social Security Number. The form in the article also includes a date field at the top and bottom.
How does a revocation of life sustaining agreement differ from a living will?
A living will typically expresses a desire to decline life-sustaining treatment in certain circumstances, while a revocation of life sustaining agreement does the opposite: it revokes such a living will and requests life-sustaining treatment even after a terminal diagnosis. The article shows that the revocation document explicitly states a wish contrary to a previous living will. Thus, it serves to override prior directives.
Can I revoke a living will without a lawyer?
The article does not address whether a lawyer is required, but it provides a self-executing form with fields for signatures and witnesses. This suggests that an individual can complete the document without a lawyer, provided they follow legal requirements. However, consulting a legal professional is advisable to ensure validity, though this is not mentioned in the article.
