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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 bills.
If a reasonable amount of time passes and I fail to ask
for at least one of the following:
______ Glass of wine
______ Cold Beer
______ Chicken fried steak and cream gravy
______ French fries
______ Bowl of ice cream
______ Cup of tea
______ All of the above,
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.