I, __________________________, being of sound mind and body, do not wish
to be kept alive indefinitely by artificial means.
Under no circumstances should my fate be put in the hands of pinhead
politicians who couldn't pass ninth-grade biology if their lives
depended on it, or lawyers/doctors interested in simply running up the
If a reasonable amount of time passes and I fail to ask for at least one
of the following:
______a cold beer
______a glass of wine
______a Bloody Mary
______a Scotch and soda
______a Vodka and Tonic
______ a Bourbon on the rocks
______Lobster or crab legs
______The remote control
______a Bowl of ice cream
______The sports page
______ a new rifle
it should be presumed that I won't ever get better.
When such a determination is reached, I hereby instruct my appointed
person and attending physicians to pull the plug, reel in the tubes and
call it a day.