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My Last Wishes

This document is intended to make known my personal wishes in the event I should die, or that I am unable to make medical decisions for myself. I, Kristoffer David Knigga, residing at 7568 West 250 South, in the City of Russiaville, State of Indiana, being at least eighteen (18) years of age and of sound mind, willfully and voluntarily make the following declarations:

 

Life Support
If at any time my attending physician certifies in writing that: (1) I have an incurable injury, disease, or illness; (2) my death will occur within a short time; and (3) the use of life prolonging procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld or withdrawn and that I be permitted to die naturally with only the performance or provision of any medical procedure or medication necessary to provide me with comfort care or to alleviate pain, and, I do not wish to receive artificially supplied nutrition and hydration, if the effort to sustain life is futile or excessively burdensome to me.

Organ Donation
In the event of my death I wish to keep all of my internal and external organs, and to not donate, trade, or sell them for any purpose. Further, with the exception of blood or plasma, I wish to not receive any transplanted tissue or organs, even if it is necessary to save my life.

Resuscitation
I request that in the event my heart and breathing should stop, no person shall attempt to resuscitate me.

 

In the absence of my ability to give directions regarding the use of life prolonging procedures, it is my intention that this declaration be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and accept the consequences of the refusal.

I understand the full import of this declaration. Executed in the County of Howard, State of Indiana.

Kristoffer David Knigga
28th day of June, 2006


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