LIVING WILLS ESTATE PLANNING Living Wills STATUTORY FORM

LIVING WILLS & ESTATE PLANNING

Living Wills • STATUTORY FORM

Living Wills Declaration made this ____ day of __________, 2015, I, JANE DOE, willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare that, if at any time I am incapacitated and _____ I have a terminal condition or _____ I have an end-stage condition or _____ I am in a persistent vegetative state and if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain. It is my intention that this declaration be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and to accept the consequences for such refusal. In the event that I have been determined to be unable to provide express and informed consent regarding the withholding, withdrawal, or continuation of life-prolonging procedures, I wish to designate the following persons in the following order as my surrogate to carry out the provisions of this declaration: Name: Address: Phone: I understand the full import of this declaration, and I am emotionally and mentally competent to make this declaration. Additional Instructions (optional): _____________________________________________________________ JANE DOE WITNESSES: Name: 818 North A 1 A, Suite 104 Ponte Vedra Beach, FL 32082 (904) 356 -2600 _______ Name: _________ 818 North A 1 A, Suite 104 Ponte Vedra Beach, FL 32082 (904) 356 -2600

Meaning of Terms MEMORANDUM The draft of your living will gives you three choices about when lifeprolonging procedures should be withdrawn. You may have life-prolonging procedures withdrawn under any one, two, or all three of the following conditions: 1. _____if you have a terminal condition; 2. _____ you have an end-stage condition; or 3. _____if you are in a persistent vegetative state. In order to assist you in understanding your choices and the living will itself, the following are the definitions, from the appropriate statute, of the terms terminal condition, end-stage condition, and persistent vegetative state. 1. Terminal Condition means a condition caused by injury, disease, or illness from which there is no reasonable medical probability of recovery and which, without treatment, can be expected to cause death. 2. End-stage Condition means an irreversible condition that is caused by injury, disease, or illness which has resulted in progressively severe and permanent deterioration, and which, to a reasonable degree of medical probability, treatment of the condition would be ineffective. 3. Persistent vegetative state means a permanent and irreversible condition of unconsciousness in which there is: a. the absence of voluntary action or cognitive behavior of any kind; and, b. an inability to communicate or interact purposefully with the environment. You should also note that the living will directs that � life-prolonging procedures be withheld or withdrawn under the circumstances described in the living will. Life-prolonging procedure under the statute means the following: any medical procedure, treatment, or intervention, including artificially provided sustenance and hydration, which sustains, restores, or supplants a spontaneous vital function. The term does not include the administration of medication or performance of medical procedure, when such medication or procedure is deemed necessary to provide comfort care or to alleviate pain. You will note that (unlike the case under prior law) life-prolonging procedures include the provision of food and water through a feeding tube. Thus, under the circumstances described in the living will, a feeding tube would not be provided or would be withdrawn. However, if you wish, you may choose to have a feeding tube. If that is your wish, please let us know and we can amend the living will accordingly, so that you will be kept alive with a feeding tube.

Provider Can Not Require • THAT PATIENT EXECUTE OR WAIVE A LIVING WILL • THAT PATIENT USE THE PROVIDER’S FORM OF LIVING WILL

Procedure • LIVING WILL THAT APPOINTS SURROGATE: EASY – SURROGATE IMPLEMENTS PATIENT’S DESIRES • LIVING WILL THAT DOESN’T APPOINT SURROGATE: A LITTLE HARDER – “PROXY”, A PERSON DESIGNATED BY STATUTE, IMPLEMENTS PATIENT’S DESIRES • SURROGATE WITHOUT LIVING WILL: ALSO A LITTLE HARDER – SURROGATE IMPLEMENTS WHAT SURROGATE BELIEVES PATIENT WOULD WANT, OR WHAT IS IN PATIENT’S BEST INTEREST • NO SURROGATE AND NO LIVING WILL: HARDEST – DECISION MADE BY PROXY, MUST BE SUPPORTED BY “CLEAR AND CONVINCING EVIDENCE” OF PATIENT’S DESIRES, OR IF DESIRES UNKNOWN, PATIENT’S BEST INTEREST

Estate Planning • MAJOR EXEMPT ASSETS 1. HOMESTEAD 2. IRAs (INCLUDING INHERITED IRAs) AND QUALIFIED PLANS 3. ANNUITIES & LIFE INSURANCE CASH VALUE 4. TRUSTS CREATED BY OTHERS 5. TENANTS BY THE ENTIRETIES PROPERTY

Estate Planning • ESTATE TAXES 1. ESTATE TAX EXEMPTION - $5 MILLION, INDEXED TO INFLATION. 2015 AMOUNT IS $5, 430, 000 PERSON 2. “PORTABILITY” OF ESTATE TAX EXEMPTION – NO LONGER “USE IT OR LOSE IT”

Estate Planning • PUTTING IT ALL TOGETHER – TITLING OF ASSETS, PROVISIONS OF WILL/LIVING TRUST, AND DESIGNATION OF BENEFICIARIES 1. TITLE HOMESTEAD JOINTLY; MINIMIZE MORTGAGE 2. ANNUITIES AND CASH SURRENDER VALUE LIFE INSURANCE IN MD’S NAME 3. PORTFOLIO ASSETS IN SPOUSE’S NAME 4. DON’T RELY ON TENANTS BY THE ENTIRETIES 5. SPOUSE’S WILL/LIVING TRUST SHOULD CREATE TRUST FOR BENEFIT OF MD 6. LIFE INSURANCE BENEFICIARY: DESIGNATE TRUST(S) FOR BENEFIT OF SPOUSE 7. ANNUITIES, IRAs, AND 401(K) BENEFICIARIES: SPOUSE FIRST, THEN TRUST FOR SPOUSE AND CHILDREN SECOND