There are various ways
in which we can make
known the instructions
for our final moments in
this life; one such
instrument is called a
Living Will. Below is a
sample of a Living Will
that might be helpful to
you as you make your own
personal decisions about
this very personal
matter. Two thinks to
consider. First of all
this is only a sample
and you should consult a
professional for advice
in such matters. Also
and equally important is
that you can always add
your Christian
perspective to such
instruments as Living
Wills. This sample gives
some examples that
should help give you
some ideas about how you
can create your
“Christian Living Will.”
LIVING WILL of
________________________
My Advance Directives
Concerning the End of my
Physical Life
DECLARATION made this
_____ day of __________,
200__.
I, __________________,
of ________________,
City of Cheyenne, County
of Laramie, State of
Wyoming, being of sound
mind and memory,
willfully and
voluntarily make known
my desire that my dying
shall not be
artificially prolonged
under the circumstances
set forth below, do
hereby declare:
I believe in the
Biblical dignity and
sanctity of life and
that to take a life
unlawfully or to impose
active euthanasia is
murder. (Genesis
9:6, "Whoever sheds
the blood of man, by man
shall his blood be shed;
for in the image of God
has God made man.)
I believe that God
sometimes chooses to
intervene with
miraculously healing no
matter how desperate the
apparent physical
condition might appear.
(2
Kings 20:5-6, "Go
back and tell Hezekiah,
the leader of my people,
'This is what the LORD,
the God of your father
David, says: I have
heard your prayer and
seen your tears; I will
heal you. On the third
day from now you will go
up to the temple of the
LORD. I will add fifteen
years to your life;
John 11:4, When he
heard this, Jesus said,
"This sickness will not
end in death. No, it is
for God's glory so that
God's Son may be
glorified through it.")
I believe that God has
an appointed time for
each person’s separation
from this life, just as
He had an appointed a
time for Christ’s death.
(Ecclesiastes
3:1-2, There is a
time for everything, and
a season for every
activity under heaven: a
time to be born and a
time to die;
2 Kings 13:14, When
Elisha became sick with
the illness of which he
was to die;
Luke 12:25, Who of
you by worrying can add
a single hour to his
life;
Job 1:21, Naked I
came from my mother's
womb, and naked I will
depart. The LORD gave
and the LORD has taken
away; may the name of
the LORD be praised;
John 12:23-24, Jesus
replied, "The hour has
come for the Son of Man
to be glorified. I tell
you the truth, unless a
kernel of wheat falls to
the ground and dies, it
remains only a single
seed. But if it dies, it
produces many seeds.)
I believe death is not
to be feared but that it
can be a wondrously
beautiful and gracious
event for the one who
has trusted in Christ
alone for their
salvation and long to be
with their Savior in
eternity. (Ecclesiastes
3:11, He has made
everything beautiful in
its time. He has also
set eternity in the
hearts of men; yet they
cannot fathom what God
has done from beginning
to end.
Hebrews 2:14-15,
Since the children have
flesh and blood, he too
shared in their humanity
so that by his death he
might destroy him who
holds the power of death
— that is, the devil—
and free those who all
their lives were held in
slavery by their fear of
death;
2 Corinthians 5:8,
We are confident, I say,
and would prefer to be
away from the body and
at home with the Lord.)
Therefore I make the
following declarations
wanting to please the
Lord even in my death. (John
5:30 …I seek not to
please myself but him
who sent me;
Romans 14:7-8, For
none of us lives to
himself alone and none
of us dies to himself
alone. If we live, we
live to the Lord; and if
we die, we die to the
Lord. So, whether we
live or die, we belong
to the Lord;
John 21:19, Jesus
said this to indicate
the kind of death by
which Peter would
glorify God.
1. If at any time I
should have an incurable
injury, disease or other
illness certified to be
a terminal condition by
two (2) physicians who
have personally examined
me, one (1) of whom
shall be my attending
physician, and the
physicians have
determined that my death
will occur whether or
not life-sustaining
procedures are utilized
and where the
application of
life-sustaining
procedures would serve
only to artificially
prolong the dying
process, I direct that
such procedures be
withheld or withdrawn,
and that I be permitted
to die naturally with
only the administration
of medication or the
performance of any
medical procedure deemed
necessary to provide me
with comfort care. In
the event that the only
procedure I am being
provided is artificial
nourishment, I direct
that artificial
nourishment be then
discontinued.
2. If such
life-sustaining measures
are to be withheld or
withdrawn, I request
that any form of
medication deemed
necessary by my
physician, to provide me
with comfortable care or
to alleviate pain be
used even if it makes me
drowsy, sleep more than
otherwise, or may
potentially hasten the
moment of death.
3. If life-sustaining
measures are to be
withheld or withdrawn, I
request that my family
be allowed at my bedside
as much as possible,
that Christian pastoral
care be given such as
prayer and scripture
reading, and that
Christian music be part
of my environment even
if it is determined that
I am unconscious, brain
death, or in a supposed
permanently vegetative
state.
4. In the absence of my
ability to give
directions regarding the
use of life-sustaining
procedures, it is my
intention that this
declaration shall be
honored by my family and
physician (s) as the
final expression of my
legal right to refuse
medical or surgical
treatment and accept the
consequences from this
refusal. I understand
the full import of this
declaration and I am
emotionally and mentally
competent to make this
declaration.
5. It is my intention
that the directions of
this Living Will be
followed in any state or
jurisdiction in which I
may be.
NOTICE
This document has
significant medical,
legal and possible
ethical implications and
effects. Before you sign
this document, you
should become completely
familiar with these
implications and
effects. The operation,
effects and implications
of this document may be
discussed with a
physician, a lawyer and
a clergyman of your
choice.
IN WITNESS WHEREOF, I
have duly signed this
Living Will at Cheyenne,
Laramie County, Wyoming,
this _____ day of
_______________, 20__.
___________________________________
The declarant has been
personally known to me
and I believe they are to
be of sound mind. I did
not sign the declarant's
signature above for or
at the direction of
declarant. I am not
related to the declarant
by blood or marriage,
entitled to any portion
of the estate of the
declarant according to
the laws of intestate
succession or under any
will of the declarant or
codicil thereto, or
directly financially
responsible for
declarant's medical
care.
___________________________________
WITNESS
___________________________________
WITNESS
STATE OF WYOMING )
) ss.
COUNTY OF LARAMIE )
Acknowledged, subscribed
and sworn to before me
by
_______________________,
the declarant, and
_____________________
and
________________________,
witnesses, as the
voluntary act and deed
of the declarant this
_____ day of __________,
2000.
___________________________________
Notary Public
My Commission Expires:
I,______________________,
of __________, am of
sound mind, and I
voluntarily make this
declaration.
Precious in the sight of
the LORD is the death of
his saints.
Psalm 116:15