A Letter to My Family, My Friends and My Health Care Providers Concerning End-of-Life Matters

This letter addresses medical issues that may arise near the end of my life. I request that those involved in making decisions for me at that time do so only after careful consideration of what I say here. As no one can predict specific circumstances, I do not wish to bind those decisions in any way but to request that they be made in light of my preferences, in light of my best interests, and in light of the best interests of my family. It is my hope that those involved, after carefully listening to each other, would come to agreement as to the best course of action. If division persists, I hereby appoint _______________ as the final arbiter and as my health care power of attorney. If ________ cannot serve, then I appoint __________.

I fully appreciate that your decisions may hasten my death.  No one should feel guilty in making such decisions or feel that the only way to show love for me is to prolong my life as long as possible. The opposite may be true.

Pain. Health care providers may fail to administer adequate pain medication in fear that it might addict or kill. My request is that I receive medication adequate to relieve my pain even if that runs the risk of creating addiction or hastening my death. I further request that none of my family or friends institute any action against any of my health care providers premised on the notion that I received too much pain medication and, furthermore, that they resist any governmental action against my health care providers, whether by prosecuting or licensing agencies, premised on that notion.

End-of-Life Medical Treatment. I do not want my life extended by medical interventions if my prognosis is grim in terms of my ultimate recovery and the quality of life. I realize that some health care providers, fearful of malpractice claims, may pursue aggressive treatment even if that is unwarranted. I request that none of my family institute any malpractice action premised on the notion that the treatment I received was not aggressive enough.

As a general matter, I disfavor cardiopulmonary resuscitation in any form and artificially administered food and fluids. I expressly authorize my family to reject, on my behalf, any form of resuscitation and to decline or later remove any forms of artificial administration of food or fluid. I want my family to know that death due to lack of hydration is not a horrible way to die; in fact it is rather peaceful and painless.

Furthermore, I would prefer not to be taken to the hospital.

Death. I would much prefer to die at home or in a hospice. I do not want to die alone or among strangers. I do not want to die in an intensive care unit or in a nursing home. If I am in intensive care for more than one week, then I strongly suspect that my life is being artificially extended.  I consent to organ donations and to an autopsy realizing that much can be learned from it to understand the cause of my death and to help others. Though I want to help my fellow humans, I am somewhat leery of experimental treatments and research studies.

Finally, as to burial, I prefer cremation and an Irish Wake. 

I intend that this letter, which I shall sign before witnesses, shall be as legally binding and as enforceable as my Living Will and Appointment of Health Care Agent as is provided in any state in which I reside at the time that this letter would be effective. Furthermore, I intend that my wishes be binding on my estate.

Signed: _________________________________

 Dated: __________________________________

 Witnessed by: _____________________________

 We, the author’s family members, have read and discussed this letter with the author. We understand it and agree to follow it.

 Signed: __________________________________