© 2004 Susan Chana Lask All Rights Reserved.

LIVING WILL OF PAMELA SMITH

To my family, my doctor, my clergyman, my lawyer:

I, PAMELA SMITH, of 100 Francis-Lewis Boulevard, Queens Village, New York, do hereby request that in the event my doctor determines that I have a terminal illness, that my mother, ANNIE SMITH, or if she is not living, then my closest friend, JANE DOE, both of Queens, New York, shall request that my doctor cease the use of any extraordinary or artificial means, such as oxygen, kidney machines, heart appliances, intravenous feedings or any other machine of any kind, whether or not such is now in existence, to keep me alive.

Should extraordinary or artificial means, as described, be withheld in connection with my treatment pursuant to the directives contained in this document, then my illness, disease or condition shall be permitted to take its natural course, even if it is medically certain that my death will follow as a result.

My directives contained in this document shall be superior to, and take precedence over, any and all directions given at any time by any other person that I have previously expressed my desire to have my life not continued by artificial means. If I shall pass away, I do hereby authorize the doctor and/or hospital to donate my eyes to another person who may need them.

Dated: 2004                                _______________________________________

                                                   PAMELA SMITH

Witnessed by:

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