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<br /> To �Y�rcia� �y `_
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<br /> ��inq �y srdioal tr�att n�tsn th�a�9so�wnt�°t —
<br /> sx�roiaa o! �y ri�ht.s �9b d�ath �� be `
<br /> (but nat iat�ntio�ally causa) r�Y
<br /> aq�inst �onvat�tional audiaal advic�. To oxaresi��
<br /> my riqnti to chsnq� ttw looation a! �y �d#cai cara
<br /> and to haw a�•�vad to anotPwc �1iaa1 taCiiity
<br /> wc looation in orda�r to +�as'rY acat �y vishu• or
<br /> in�►tians. coaasr�itx� �ioai cu� and �� _
<br /> t�rsinaCion ol. Zit�-sustaial�q t�+ats�nt snd
<br /> artilioiaily �inistsr'�d rutx'ition aad bydratioa•
<br /> 5. �..♦w••••�r� tali�t l�t�i�a. � oons�nt to u�d _
<br /> ��yq� !� ths adaiaistration o! pafn-r�li�vinq
<br /> druqs o! any kind or otts�r surqiaal or a�dical
<br /> prac�luru calcuiatsd to r�li�va ay pain�
<br /> includinq unconvantional pain-r�li�ving druga o!
<br /> any kind� or othar surqicaa or s�dical procsduras
<br /> caiculat�d to r�iisv� �y p=in, including
<br /> unconvantional pain-r�li�! th�rapi�s which ay
<br /> attornsys in tact bsli�v� aay b� h�1Piu1, svsn
<br /> thouqh suah dr�xl� � ���uras say havs advarsa
<br /> aida �ft�cts, ssy aauss addiction, or aay haat.�n
<br /> th� a�oa�nt o!' (but no! inttntionsily caus�) �Y
<br /> d�ath. .
<br /> To qrant. in coniunctior� with any
<br /> 6• 'itutructtor�s 9lwA ksrsunds�. x�l�asss to ho�cpital
<br /> staii. pbY�iciaas. nursts aa�d ott�r a�dical and
<br /> �p�,tal �inistr:tiv� psrsonn�l *►ho act in
<br /> ' r�liancs o� inatructfcns�qiwn by sy attorn�ys in
<br /> l�ct or wbo rar�d�r writte�n opfniuons�to s�.ttar
<br /> � • at#om�y�t 3.� tacc in cvw�..:..�.... ........ a.� ---- -- _...._.--
<br /> ' d��cribed harsin irc� all liability for dasa9�
<br /> sutl4r�d or to b� sut��� by �': to sfqn
<br /> . docw�sata titl�d or p�Portin9 to b� a "Ratusal o!
<br /> Trsataaat" and "Ls�ving Hospital 1►qafnst 1�lical
<br /> AdViG~ as wa21 as any a�ceasarY wa ivars o! or
<br /> r�l�asss lrca lixbility r�quirsd by a hos�itnl or
<br /> � pLysici�.
<br /> ?. To rssign by
<br /> th� �x�cution o� a� writtsn r�siqnation dalivar�d
<br /> to a� or, i! i a� �ntaliy incapsaitat�, bY .
<br /> dslivary to any psrscun i�eJsily authoris� to
<br /> c o n�v�t aY a l L a i r s a A d a b s a n t s u c h �w rson than to .
<br /> amy p�rson with vho= I as rqaiding or who has ths �
<br /> cars snd custody or �, or� in ths cas� o! a
<br /> ruiynation o! .a� succsasor attornsy in laat, by
<br /> d�livsry to �y attort�y� in fact.
<br /> g. pnot.�aooi�s_._ To sax� photocopiss ot this
<br /> instru�at as frequantl�• and in such qixan�itiss a�
<br /> � ay attornoya i�n lact shall de� appropriat�. 1111
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