AFOVA New Letter 2 of Year 2021

Section 7 – Panorama CV 2 No. 02 / 2021 Page 313 of 332 LIVING WILL This Declaration on My Life is made by me (full name) Date of Birth Aadhaar Address on (date) at (place) I am an adult, of sound mind and am making this ‘Declaration’ of my own free will, voluntarily and after careful consideration. If the time comes that I can no longer take part in decision making regarding my medical treatment, this ‘ Declaration ’ will comprise the final expression of my wishes. It is requested that all concerned should take these wishes into account before taking any medical decision regarding my life. If at any time, I 1. Reach the stage of terminal illness and go into a coma with no reasonable expectation of regaining consciousness, or 2. Have a disease state from which I have no reasonable expectation of recovering with acceptable quality of life 3. Reach a persistent vegetative stage with no reasonable expectation of regaining significant cognitive functioning Then, the following steps must be taken. I request that a panel of three doctors of appropriate expertise and experience should be constituted by the administrative head of the hospital where I am admitted for treatment. Their views should then be sought on the above. If any/all of the three situations above are confirmed then I should be deemed to have declined to receive the following life sustaining treatments as listed below. Any of these measures already started, should be removed. 1. Intravenous fluids and medications including antibiotics 2. Artificial feeding by nasogastric tube or gastrostomy 3. Dialysis 4. Artificial respiration 5. Chemotherapy 6. Cardio-pulmonary resuscitation Other wishes: (please write by hand)