I, __________________________, being of sound mind and body, do not wish to be kept alive indefinitely by artificial means. Under no circumstances should my fate be put in the hands of pinhead politicians who couldn't pass ninth-grade biology if their lives depended on it, or lawyers / doctors interested in simply running up the bills. If a reasonable amount of time passes and I fail to ask for at least one of the following:
______Glass of wine ______Margarita ______Martini ______Cold Beer ______Chicken fried steak and cream gravy ______Mexican food ______French fries ______Pizza ______Bowl of ice cream ______Cup of tea ______Chocolate ________Sex
It should be presumed that I won't ever get better. When such a determination is reached, I hereby instruct my appointed person and attending physicians to pull the plug, reel in the tubes and call it a day.