Persistent Vegetative State
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A HEALTH CARE DIRECTIVE FORM
health.hawaii.govStreet Address City State Zip Part 1: INDIVIDUAL INSTRUCTIONS FOR HEALTH CARE The following statements only apply • if I am close to death and life support would only postpone the moment of my death OR • if I am in an unconscious state such as an irreversible coma or a persistent vegetative state and it is unlikely that I will ever
Date of Directive - Idaho Secretary of State
sos.idaho.govb. I have been diagnosed as being in a persistent vegetative state. In such event, I direct that the following marked expression of my intent be followed and that I receive any medical treatment or care that may be required to keep me free of pain or distress. Check . one. box and initial the line after such box:
HEALTH CARE DIRECTIVE (LIVING WILL)
hov.orgUnconscious (chronic coma or persistent vegetative state) Unable to communicate my needs Unable to recognize family or friends Total or near total dependence on others for care Other: Check only one: Even if I have the quality of life described above, I still wish to be treated with food and water by tube or intravenously (IV).
Clinical Practice Guidelines: Resuscitation/General guidelines
www.ambulance.qld.gov.au- a persistent vegetative state involving severe and irreversible brain damage; - permanently unconscious and has brain damage so severe that there is no reasonable prospect of the patient regaining consciousness; or - an illness or injury of such severity that there is no reasonable prospect of recovery.