Homepage Attorney-Approved Living Will Document for New Hampshire
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When facing the often uncomfortable yet vitally important task of planning for future healthcare decisions, many individuals turn to documents like the New Hampshire Living Will form. This legal instrument allows a person to outline their wishes concerning medical treatment and life-sustaining measures in the event they are unable to communicate their desires due to incapacitation. Recognized under New Hampshire law, the form is a critical aspect of advance directives, enabling individuals to assert control over their healthcare by specifying which treatments they wish to accept or refuse, and under what circumstances. Furthermore, it affords a way to appoint a health care representative who will ensure that these directives are adhered to, adding a layer of personal advocacy. Central to the conversation on patient autonomy and dignity, the New Hampshire Living Will form encapsulates the confluence between legal forethought, medical ethics, and personal freedoms, highlighting its significance in the broader discourse on end-of-life care.

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New Hampshire Living Will

This Living Will is made in accordance with the New Hampshire Advance Directives laws, RSA 137-J. It serves to document the desires of the undersigned regarding medical treatment in situations where they are unable to make decisions for themselves due to incapacity or terminal illness.

Part 1: Information of the Declarant

Name of Declarant: _________________________________

Date of Birth: ______________________________________

Address: ___________________________________________

City: ______________________ State: NH Zip: __________

Phone Number: _____________________________________

Part 2: Treatment Preferences

This section documents your preferences regarding the acceptance or refusal of medical treatment, including life-sustaining treatment and artificially provided nutrition and hydration, under certain conditions.

  1. I do not want my life to be prolonged if (check one):

    ____ I am in a terminal condition with an irreversible cessation of all functions of the brain, including the brain stem, as confirmed by two physicians.

    ____ I am in a permanent unconscious condition (persistent vegetative state) with no reasonable chance of regaining consciousness, as confirmed by two physicians.

  2. I wish to receive/decline (circle one) the following types of treatments if I am in the conditions described above:

    ____ Life-sustaining treatments, including CPR, mechanical ventilation, and dialysis.

    ____ Artificially provided nutrition (feeding tube) and hydration.

  3. Other instructions:

    ______________________________________________________

    ______________________________________________________

Part 3: Signature

This document represents my directions as the undersigned. By signing below, I confirm that I understand the purpose and effect of this document.

Date: _______________ Signature: ___________________________

Part 4: Witnesses

The undersigned witnesses affirm that the declarant is of sound mind and not under undue influence. This document was signed in our presence.

Witness 1:

Name: _________________________ Date: _______________

Signature: _________________________

Witness 2:

Name: _________________________ Date: _______________

Signature: _________________________

Instructions: Keep the original copy of this living will in a safe but accessible place. Provide a copy to your physician, hospital, healthcare agent, and any other relevant parties. Review periodically and update as necessary to reflect your current wishes.

File Information

Fact Detail
Official Name New Hampshire Advance Directive
Governing Law New Hampshire Revised Statutes, Section 137-J:2 - The Right to a Natural Death; Life Sustaining Treatment
Primary Purpose To allow individuals to express their wishes regarding medical treatment and life-sustaining measures in the event they are unable to communicate their decisions.
Components Contains a Living Will and Durable Power of Attorney for Healthcare.
Required Signatures The document must be signed by the declarant and two witnesses; a notary public is optional but not required.
Witness Restrictions Witnesses cannot be the declarant's healthcare provider, an employee of the healthcare provider, or anyone entitled to any part of the declarant's estate upon death.
Revocation The declarant may revoke the directive at any time and in any manner that communicates intent to revoke, without requiring any specific formality.
Accessibility It is advisable to share copies of the completed form with healthcare providers, a legal advisor, and family members to ensure the individual's wishes are known and can be acted upon.

Detailed Instructions for Writing New Hampshire Living Will

Filling out a Living Will in New Hampshire is a proactive step toward ensuring your healthcare preferences are known and respected in situations where you may not be able to communicate them yourself. This document allows you to outline your wishes regarding medical treatment in cases of terminal illness or incapacitation. Completing this form may seem daunting, but by following these steps, you can ensure your wishes are clearly documented.

  1. Begin by obtaining a copy of the New Hampshire Living Will form. This can usually be found online or at healthcare facilities across the state.
  2. Read through the entire form before you start writing to familiarize yourself with its content and requirements.
  3. Start by entering your full legal name and date of birth at the top of the form to establish your identity.
  4. In the section labeled "Directions for Health Care," specify your wishes regarding life-sustaining treatment. This might include instructions on the use of mechanical ventilation, artificial nutrition, and hydration if you are in a terminal condition or permanently unconscious.
  5. Next, address your preferences for pain management, emphasizing the importance of being kept comfortable even if such measures shorten your life.
  6. If there are specific treatments you do not want under certain conditions, list these clearly under the section provided. Make sure to be as specific as possible to avoid any ambiguity.
  7. Designate a healthcare agent by providing the name, relationship, and contact information of the person you are appointing. This step is crucial as this individual will have the authority to make healthcare decisions on your behalf, in case you are unable to do so yourself.
  8. Include instructions for your healthcare agent, if there are any specific directions you want them to follow. These instructions should complement your treatment preferences stated earlier in the form.
  9. Review the form thoroughly to ensure all your information is accurate and your wishes are clearly stated.
  10. Sign and date the form in the presence of two witnesses or a notary public. The witnesses must also sign and print their names, confirming that you are willingly and voluntarily executing the document.
  11. Finally, make copies of the completed Living Will. Provide one to your healthcare agent, one to your primary care physician, and keep one for your personal records.

After completing and distributing your Living Will, your healthcare team and loved ones will have clear guidance on your treatment preferences should you become unable to communicate them yourself. It's a thoughtful way to provide peace of mind for yourself and those who care for you, ensuring decisions are made according to your wishes.

Essential Queries on New Hampshire Living Will

What is a New Hampshire Living Will?

A New Hampshire Living Will is a legal document that allows an individual to outline their preferences regarding medical treatment in the event they become unable to communicate their wishes due to incapacitation. This form enables a person to make decisions about life-sustaining treatments ahead of time, ensuring that their medical care aligns with their values and desires.

Who should have a Living Will in New Hampshire?

Any adult in New Hampshire who wishes to have control over their medical treatment should consider creating a Living Will. It's particularly important for those with strong feelings about certain medical treatments or those facing a potentially incapacitating medical condition. However, planning for the future and unexpected situations makes having a Living Will a sensible decision for most adults.

How do I create a Living Will in New Hampshire?

To create a Living Will in New Hampshire, you must complete a specific form outlining your healthcare wishes. This form should be filled out carefully and include detailed instructions about what medical interventions you do or do not want. After completing the form, you must sign it in the presence of two witnesses or a notary public. These witnesses must not be your health care providers or related to you by blood or marriage.

Can I change my Living Will once it's been made?

Yes, you have the right to change or revoke your Living Will at any time as long as you are of sound mind. To make changes, you can create a new Living Will or add a written amendment to your existing one. Any changes should be communicated to your healthcare provider and anyone else who has a copy of your original Living Will to ensure your current wishes are known and respected.

When does a Living Will become effective in New Hampshire?

A Living Will becomes effective in New Hampshire when you are unable to communicate your wishes regarding medical treatment. This could be due to unconsciousness, cognitive impairment, or any other condition that prevents you from expressing your preferences. For your Living Will to be acted upon, your incapacity must be confirmed by a healthcare provider.

Do I need a lawyer to create a Living Will in New Hampshire?

No, you do not need a lawyer to create a Living Will in New Hampshire. However, consulting with a legal professional can be helpful in ensuring your document is clear, comprehensive, and accurately reflects your wishes. A lawyer can also provide advice on New Hampshire's specific requirements and help with other estate planning needs.

What should I do with my Living Will once it's completed?

Once your Living Will is completed, you should provide copies to your primary healthcare provider, a trusted family member or friend, and your healthcare agent if you have designated one. It's also wise to keep a copy in a safe but accessible place where it can be easily found in an emergency. Letting your loved ones know where your Living Will is stored and what it contains can help ensure your wishes are followed.

Common mistakes

In the realm of planning for the future, particularly concerning health care decisions, the New Hampshire Living Will form serves as an essential tool for conveying individuals' wishes. Regrettably, during the process of filling out this significant document, numerous individuals fall prey to a variety of mistakes. These errors can, unfortunately, lead to the misinterpretation of their intentions or, even worse, render the document legally ineffective. Recognizing and avoiding these pitfalls can ensure that one's health care preferences are respected and followed.

One common mistake is overlooking the requirement to have the document witnessed or notarized, depending on the state’s statutes. This oversight can invalidate the document, causing unnecessary legal complications during a critical time. A thorough review of New Hampshire’s specific requirements is essential to ensure that all legal criteria are met.

  1. Not specifying detailed health care preferences. Many people generalize their wishes without providing specific instructions on treatments they want or do not want, leading to potential ambiguity during critical health care decisions.
  2. Failing to update the document. Life changes such as new diagnoses, changes in marital status, or shifts in health care philosophies necessitate updates to the Living Will to accurately reflect current wishes and circumstances.
  3. Omitting the appointment of a durable power of attorney for health care. Not designating a trusted individual to make health care decisions when one is unable to do so can complicate the execution of the Living Will's instructions.
  4. Lack of communication with the appointed health care agent. Without clear discussions about one’s health care preferences, the appointed agent may be unaware of the specific wishes or the existence of the document itself.
  5. Not discussing the Living Will with family members. Failing to discuss one's wishes with family members can lead to conflicts or confusion during emotional times, potentially leading to disputes over health care decisions.
  6. Ignoring state-specific requirements. Each state has unique requirements for Living Wills. Neglecting to adhere to New Hampshire's specific regulations can invalidate the document.
  7. Using vague or contradictory language. Ambiguous expressions in the Living Will can lead to interpretations that might not align with one’s actual wishes, causing disputes among medical providers and family members.
  8. Forgetting to sign and date the document. An unsigned or undated Living Will is not legally binding, rendering the document ineffective at a crucial time.
  9. Not storing the document in an accessible place. If health care providers or the appointed health care agent cannot find the Living Will, it is as though it does not exist.
  10. Assuming that the Living Will is sufficient for all end-of-life decisions. A Living Will is critical, but it is also important to have a comprehensive estate plan that includes other documents like a durable power of attorney for finances.

To mitigate these mistakes, individuals should approach the completion of the New Hampshire Living Will form with meticulous attention to detail and a commitment to ongoing updates. Engaging in open dialogues with designated health care agents, family members, and, if possible, a legal advisor familiar with New Hampshire law can provide invaluable insights. Empowering oneself with knowledge and foresight can ensure that one’s health care wishes are effectively communicated and respected, thus providing peace of mind in unforeseen future health care circumstances.

Ultimately, the goal of a Living Will is to provide clarity and direction for health care decisions when individuals can no longer communicate their wishes themselves. By avoiding these common pitfalls, individuals can ensure that their Living Will serves its intended purpose, thereby upholding their autonomy and ensuring their health care preferences are honored.

Documents used along the form

Preparing for future medical care includes more than just completing a Living Will. It's essential to understand the various forms and documents that can complement a Living Will, especially in New Hampshire. These documents ensure that an individual's healthcare preferences are fully documented and respected. Below is a list of forms that are often used alongside a New Hampshire Living Will to provide a comprehensive approach to end-of-life planning.

  • Durable Power of Attorney for Health Care: This document allows an individual to appoint someone else to make health care decisions on their behalf if they are unable to do so.
  • Do Not Resuscitate (DNR) Order: A DNR order instructs healthcare providers not to perform CPR if a person's breathing stops or if their heart stops beating.
  • Medical Orders for Life-Sustaining Treatment (MOLST): This form provides specific instructions about certain types of life-sustaining treatments based on a person's health condition and preferences.
  • Organ and Tissue Donation Registration: This registration makes one's wishes about organ and tissue donation legally binding, and it is typically included in a state's registry.
  • HIPAA Release Form: The Health Insurance Portability and Accountability Act (HIPAA) release form authorizes the disclosure of an individual's health information to designated persons.
  • Emergency Contact Form: Although not legally binding, an emergency contact form is crucial for informing family members, friends, or caregivers about who should be contacted in case of an emergency.
  • Guardianship Designation: This document allows an individual to designate a guardian for themselves in the event that they become unable to make their own decisions.
  • Funeral Directives: This document outlines an individual's preferences for their funeral arrangements, including burial or cremation, type of ceremony, and other specifics.
  • Property Power of Attorney: Separate from healthcare, this form designates someone to handle financial and property matters if the individual is unable to do so.
  • Advance Directive Amendment Form: Used to make changes or updates to an existing advance directive, ensuring that it always reflects current wishes and circumstances.

While the Living Will addresses critical aspects of end-of-life care, the associated forms and documents provide a more comprehensive framework for managing healthcare, personal, and financial decisions. Ensuring that all these forms are properly completed and accessible to relevant parties can offer peace of mind to individuals and their families, knowing that their wishes are documented and legally protected.

Similar forms

The New Hampshire Living Will form is similar to several other legal documents that allow a person to outline their wishes for medical care, but it has its distinct features and purposes. Three central documents share similarities with the New Hampshire Living Will form: Health Care Power of Attorney, Do Not Resuscitate (DNR) Order, and Advance Directive. Each document plays a unique role in managing health care preferences and legal considerations.

The first similar document is the Health Care Power of Attorney (HCPOA). Like the Living Will, a HCPOA allows individuals to express their wishes regarding medical treatment. However, the key difference lies in how these wishes are executed. A Living Will typically specifies preferences for end-of-life care directly within the document itself, acting when the individual is unable to communicate. In contrast, a Health Care Power of Attorney appoints another person, known as a health care agent or proxy, to make health care decisions on the individual’s behalf when they are incapacitated. This distinction underscores the Living Will’s focus on direct instructions, while the HCPOA emphasizes choosing a trusted individual to make decisions.

Another document that bears resemblance to the Living Will is the Do Not Resuscitate (DNR) Order. DNR orders are specific medical orders written by a doctor which prevent life-saving emergency procedures in cases where a person's breathing or heart stops. Similar to Living Wills, DNRs articulate a clear preference regarding a specific type of medical intervention, specifically resuscitation. However, while Living Wills cover a broader range of end-of-life care preferences, a DNR strictly focuses on the absence of CPR or advanced life support techniques in emergency situations. This delineation reveals the comprehensive nature of Living Wills in addressing various aspects of end-of-life care beyond resuscitation.

Finally, the New Hampshire Living Will form is closely related to an Advance Directive. Often, the term Advance Directive is used as an umbrella term that can include multiple types of documents, including Living Wills and Health Care Powers of Attorney. The overarching goal of an Advance Directive is to guide medical treatment when a person is unable to make decisions themselves. While a Living Will is one component of an Advance Directive, focusing on the refusal or acceptance of life-sustaining treatments, Advance Directives may also encompass a broader range of decisions and preferences. Thus, while all Living Wills can be considered a form of Advance Directive, not all Advance Directives are Living Wills, pointing to the flexible and comprehensive nature of planning for future health care.

Dos and Don'ts

When filling out the New Hampshire Living Will form, individuals are encouraged to approach the document with careful consideration due to its significance in conveying one's medical desires. It is essential to ensure that all information is accurately represented, reflecting personal wishes regarding life-sustaining treatment in the event of incapacitation. The following guidelines serve as a framework to assist in completing the form effectively and thoughtfully.

  • Do read the entire form before starting to fill it out to familiarize yourself with its contents and requirements.
  • Don't rush through the process. Take your time to consider each section and how it aligns with your healthcare wishes.
  • Do ensure that you fully understand the medical terms and implications of each choice available on the form. If necessary, seek clarification from a healthcare professional.
  • Don't leave any sections incomplete. If a section does not apply, indicate this clearly to avoid any ambiguity.
  • Do discuss your decisions with close family members or friends, as well as your primary healthcare provider, to ensure they understand your wishes.
  • Don't forget to sign and date the form. In New Hampshire, a Living Will must be either notarized or signed in the presence of two witnesses who are not beneficiaries.
  • Do keep the original document in a safe but accessible place, and provide copies to trusted individuals, including your healthcare proxy, if you have appointed one, and your primary care physician.
  • Don't assume that completing a Living Will is a one-time task. Revisit and, if necessary, revise the document as your health status or preferences change.
  • Do remember that a Living Will is legal in New Hampshire and should be respected by healthcare providers, but it is also important to have discussions with these providers to ensure they are aware of and understand your directives.

Misconceptions

When it comes to preparing a Living Will in New Hampshire, several misconceptions often arise. Understanding these can help clarify what a Living Will is and how it works, ensuring that individuals can make informed decisions about their future healthcare.

  • A Living Will is the same as a Last Will and Testament: While both documents are vital for planning one’s affairs, they serve different purposes. A Living Will expresses one's wishes regarding medical treatment in situations where they are no longer able to communicate these decisions themselves. In contrast, a Last Will and Testament deals with the distribution of one's assets after death.

  • Once completed, a Living Will cannot be changed: This is incorrect. As circumstances change, so too might one's preferences regarding healthcare. In New Hampshire, individuals can update or cancel their Living Will at any time, provided they are of sound mind when doing so.

  • A Living Will is only for the elderly or terminally ill: This misconception could prevent younger or healthier individuals from preparing for unforeseen health crises. A Living Will is advisable for any adult, as it speaks to situations where one cannot make decisions due to incapacitation, not just terminal illness or old age.

  • You need a lawyer to create a Living Will: While professional legal advice might be beneficial, particularly in complex situations, it is not a strict requirement. New Hampshire provides resources and straightforward forms that individuals can complete on their own to establish a Living Will. However, it's crucial that the form meets all legal requirements and is signed in the presence of witnesses.

  • A Living Will automatically makes all medical decisions for you: A Living Will outlines specific wishes for end-of-life care but does not encompass all medical decisions. It goes into effect only under certain conditions, such as terminal illness or permanent unconsciousness. Additionally, one can appoint a healthcare proxy in a separate document, giving someone they trust the authority to make other medical decisions on their behalf.

Key takeaways

In New Hampshire, individuals have the right to make decisions regarding their health care through the use of a Living Will form. Here are some key takeaways regarding the completion and application of this vital document:

  • It's imperative that the person filling out the form, known as the declarant, is at least 18 years old or a legally emancipated minor, and fully competent to make health care decisions.
  • The Living Will form allows individuals to outline their wishes regarding medical treatment and life-sustaining measures in the event they are no longer able to communicate their desires due to incapacity or terminal illness.
  • To ensure the Living Will is legally binding, it must be signed in the presence of two witnesses, who also need to sign the document. These witnesses cannot be health care providers directly involved in the declarant’s care or be related to the declarant by blood, marriage, or adoption.
  • It's crucial for the declarant to discuss their wishes with their chosen health care agent, family, and relevant health care providers to ensure their desires are clearly understood and can be followed.
  • The document can be revoked or altered at any time by the declarant, as long as they are competent. This can be done through a written revocation, destruction of the document, or by verbally expressing the desire to revoke in the presence of a witness.
  • Having a Living Will does not affect any financial obligations regarding medical care; it solely addresses the types of treatment the declarant wishes or does not wish to receive.
  • The form should be kept in a safe but accessible place. Copies should be provided to the declarant’s health care agent, primary physician, and family members to ensure the document can be easily retrieved when needed.
  • In situations where the Living Will's directives are in conflict with the desires of the family or health care providers, legal advice may be sought to resolve these disputes according to the declarant's expressed wishes.

Completing a Living Will form is a responsible step toward ensuring one's health care preferences are respected during critical times. It provides peace of mind for both the individual and their loved ones, knowing that personal wishes are clearly documented and legally recognized.

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