Good Initial Plan

Go online to complete your Clear and Comprehensive Living Will using My Way Cards

My Way Cards examples

For Most:
No Suffering

For Most:
Severe Enough Suffering

Condition 0.0 Condition 8.3
Condition 3.3 Condition 3.3

People’s judgments vary

Condition 4.5 Condition 5.5

 

Better Diligent Plan

Refine and memorialize your Clear and Comprehensive Living Will so it is consistent by recording your interview on video.

Best Strategic Plan

Strengthen your Clear, Comprehensive, Consistent, and Convincing Living Will by adding compelling strategies.


  • Generate your living will online by using the revolutionary My Way Cards.
  • Use the same criterion for advanced dementia that physician–assisted dying uses: you reached a condition that causes severe enough suffering.
  • Use your personal values to express your judgment about 50 conditions: state which would cause you severe enough suffering to want to be allowed to die.
  • Your responses can provide a clear answer to the Living Will “when question.”
  • Together, the 50 conditions comprehensively include what people dread most about prolonged dying in the terminal stage of any disease, especially advanced dementia.
  • Receive your Natural Dying Living Will as a PDF by email, and printed by US Postal Service.
  • Receive a Proxy Directive valid in your state, to legally designate your proxies/agents so they can advocate the treatment decisions YOU made (or make decisions on your behalf).

  • Everything in the “Good Initial Plan” PLUS:
  • A clinician reviews your decisions, and...
  • Then discusses your decisions by phone.
  • Receive a form to clarify your refusal of spoon-feeding.
  • Receive a form to insist on relief from any type of unbearable suffering.
  • Receive a form to refuse thickened food and fluid in advance.
  • Receive an additional “physician-friendly” version of your Living Will that...
  • Warns physicians of possible legal consequences—
    if their orders do not honor your known wishes.
  • Receive a printed guide, “How to be convincing in your video interview.”
  • Memorialize your explanations and provide details about your wishes by recording your interview on video.
  • Everything is sent by US Postal Service, ready for your and witnesses’ signatures.

  • Everything in the “Good Initial” and “Better Diligent Plan” PLUS:
  • Instructions on creating your working “Decision Committee” using strong bilateral legal contracts.
  • Use the Natural Dying Agreement’s legal/medical/logistical strategies to overcome 14 common challenges and potential sabotage.
  • Use the Natural Dying Affidavit to summarize your wishes in a legal document that can be admitted as evidence in a court of law.
  • Complete 3 Physician Orders for Life–Sustaining Treatment (POLST) forms with orders pre–printed for your physician to sign.
  • Consider 3 scripts to record on video, your brief instructions to emergency responders.
Natural Dying Living Will My Way Cards sorting Doctor writing orders

Click for brief list


Together, these 50 conditions comprehensively include what people dread most about prolonged dying in Advanced Dementia and other terminal illnesses.

The key question: If you reached any condition that would cause severe enough suffering—do you want others not to prolong your dying and suffering?

The online decision aid My Way Cards works on your computer, tablet, and cellphone.
First, it informs you about each clinical condition.
Then it asks: “Would it cause severe enough suffering for you to want to be allowed to die?”
If “Yes,” you can choose Natural Dying—a way to die that is effective and peaceful; and that strives for others’ acceptance.

We send you a state–specific Proxy Directive so you can legally designate one person and alternates to speak for you—if you lose your ability to make medical decisions. We also send a guide on how to select and to empower your proxies/agents.

From your responses to My Way Cards, we generate and email you, your “Initial” Natural Dying Living Will. If you want to use it as your current Living Will, we print it and mail it to you by USPS, ready for signatures so that it can be legally valid.

We recommend using this Living Will as your initial draft and continuing your advance care planning efforts by reviewing your responses with diligent deliberation and discussion.

Click for brief list


Includes the “GOOD PLAN” plus...

First we review your responses to the My Way Cards. Then a clinician discusses them with you on a phone call of about 10 minutes. We ask: Are your decisions consistent with “severe enough suffering”?

Using the responses you may have revised, we generate your “Final” Natural Dying Living Will and send you a second, “physician–friendly” version that is strategic. It warns future physicians about 3 dire legal consequences—if they write orders that do not honor your known end–of–life wishes.

We send you 3 forms to add to your Living Will. They clarify your refusal of force–feeding; let you refuse thickened food and fluid in advance; and let you consent to treatment to totally relieve unbearable end–of–life pain and suffering—even if medications must put you to sleep.

We print your Living Will on brightly colored, heavy stock paper and mail it by USPS, ready for signatures so it can be legally valid.

To make your wishes convincing——we recommend you respond to an interview that you record on video, where you explain the reasons WHY you made these advance treatment decisions. If you do not select one of our trained clinicians to interview you, we mail you a short “How To” guide so your responses for your oral Living Will can strive to be convincing. (Our clinicians can record on video, their opinion: Did you have enough mental capacity to make these advance treatment decisions?)

Click for brief list


Includes the “BETTER PLAN” plus...

You add strategies designed to overcome common challenges and sources of sabotage—so you can avoid conflict, or at least promptly and privately resolve conflicts—without going to court.

For more information about why even Living Wills that are clear, consistent, and convincing may be only necessary but not sufficient to be compelling so you can attain your end–of–life goals, click here.

One strategy further empowers your proxies/agents by asking each to sign a binding bilateral contract and to form your Decision Committee. Another strategy insists on using your high standards of evidence presented by opposing experts—if others claim that you changed your mind, no longer want Natural Dying, and revoked your Natural Dying Living Will—even though you have reached a condition that you had judged would cause severe enough suffering.

One especially challenging conflict is: Your “future demented self” indicates the desire for others to help spoon–feeding but you (as expressed in your Living Will) had decided on Natural Dying for your current condition. This “Best Plan” lets you invoke a strategy to resolve this potential conflict now!

Includes 3 “physician–friendly,” comprehensive Physician Orders for Life-Sustaining Treatment (MOLST, POST, etc.) forms that have pre-printed physician orders. The first can ask for cardiopulmonary resuscitation(CPR). The second can refuse only CPR (“Do Not Attempt Resuscitation or DNR.”) The third can request “DNR plus Natural Dying.” We can provide suggested scripts so you can record 3, shorter than one–minute videos to rapidly inform emergency first responders and physicians what treatment you do, or do not want.

To get your unique link to the online program and forms by email, order the “Good Plan” for $45 by clicking here.

Optional Read: “Six Steps to Strategic Advance Care Planning”

Consider the “Better Diligent Plan”


More Detail

Everything is sent by US Postal Service, ready for your and witnesses’ signatures.

Your efforts to be consistent and convincing may be necessary but not sufficient.

Consider the need for strategies to overcome 14 common challenges: click here.

Click here for a 10-minute slide show that reveals the opposition and its dire consequences.

Consider “Best Strategic Plan”


More Detail

Click here to learn why to consider uploading to a registry.

Recommended: Upload all your forms and videos to a national registry such as MyLastWishes.org where physicians and others can quickly retrieve them.

Or

More Detail

Concerned about a loved one who reached advanced dementia lacking an adequate and effective living will?

Now Care Planning is a program that offers you and others who knew the patient well, a way to see if you reached a “Consensus of Substituted Judgments” regarding what treatment your currently demented loved one would certainly want NOW.

The goal of Now Care Planning is to motivate your loved one's current physician to write orders to prevent a prolonged dying with increased suffering.

Click to learn about Now Care Planning.

Dr. Terman devised a set of strategic solutions including ingeniously coupling a specially designed Advance Directive and a set of physician orders with adequate safeguards that reflect Dr. Terman's strong advocacy against ending life prematurely. Ironically, learning how to end life really empowers us to prolong our meaningful and enjoyable life.

Ronald B. Miller, MD, FACP, Founding Director of the Program in Medical Ethics, University of California Irvine