PARRIS N. GLENDENING, Governor

Ch. 545

(1)     If my death from a terminal condition is imminent and even if life-sustaining
procedures are used there is no reasonable expectation of my recovery -

______ I direct that my life not be extended by life-sustaining procedures, including

the administration of nutrition and hydration artificially.

______ I direct that my life not be extended by life-sustaining procedures, except that

if I am unable to take food by mouth, I wish to receive nutrition and hydration artificially.

______ I DIRECT THAT IF I AM AT OR NEAR BRAIN DEATH BRAIN DEAD, AN

ANATOMICAL GIFT BE OFFERED ON MY BEHALF TO A PATIENT IN NEED OF AN
ORGAN OR TISSUE TRANSPLANT. IF A TRANSPLANT OCCURS, I WANT ARTIFICIAL
HEART/LUNG SUPPORT DEVICES TO BE CONTINUED ON MY BEHALF ONLY UNTIL
ORGAN OR TISSUE SUITABILITY OF THE PATIENT IS CONFIRMED AND ORGAN OR
TISSUE RECOVERY HAS TAKEN PLACE.

(2)     If I am in a persistent vegetative state, that is, if I am not conscious and am not
aware of my environment or able to interact with others, and there is no reasonable
expectation of my recovery -

______ I direct that my life not be extended by life-sustaining procedures, including

the administration of nutrition and hydration artificially.

______ I direct that my life not be extended by life-sustaining procedures, except that

if I am unable to take food by mouth, I wish to receive nutrition and hydration artificially.

______ I DIRECT THAT IF I AM AT OR NEAR BRAIN DEATH BRAIN DEAD, AN

ANATOMICAL GIFT BE OFFERED ON MY BEHALF TO A PATIENT IN NEED OF AN
ORGAN OR TISSUE TRANSPLANT. IF A TRANSPLANT OCCURS, I WANT ARTIFICIAL
HEART/LUNG SUPPORT DEVICES TO BE CONTINUED ON MY BEHALF ONLY UNTIL
ORGAN OR TISSUE SUITABILITY OF THE PATIENT IS CONFIRMED AND ORGAN OR
TISSUE RECOVERY HAS TAKEN PLACE.

(3)     If I have an end-stage condition, that is a condition caused by injury, disease,
or illness, as a result of which I have suffered severe and permanent deterioration
indicated by incompetency and complete physical dependency and for which, to a
reasonable degree of medical certainty, treatment of the irreversible condition would be
medically ineffective -

______ I direct that my life not be extended by life-sustaining procedures, including

the administration of nutrition and hydration artificially.

______ I direct that my life not be extended by life-sustaining procedures, except that

if I am unable to take food by mouth, I wish to receive nutrition and hydration artificially.

______ I DIRECT THAT IF I AM AT OR NEAR BRAIN DEATH BRAIN DEAD, AN

ANATOMICAL GIFT BE OFFERED ON MY BEHALF TO A PATIENT IN NEED OF AN
ORGAN OR TISSUE TRANSPLANT. IF A TRANSPLANT OCCURS, I WANT ARTIFICIAL
HEART/LUNG SUPPORT DEVICES TO BE CONTINUED ON MY BEHALF ONLY UNTIL
ORGAN OR TISSUE SUITABILITY OF THE PATIENT IS CONFIRMED AND ORGAN OR
TISSUE RECOVERY HAS TAKEN PLACE.

______ I direct that no matter what my condition, medication not be given to me to

relieve pain and suffering, if it would shorten my remaining life.

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