Various versions of this useful instrument have been circulating recently. This one was sent by Tom Vickery.

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 peckerwood politicians who couldn’t pass ninth-grade biology if their lives depended on it.

If a reasonable amount of time passes and I fail to sit up and ask for any of the following:
(please initial all that apply)

_____ a martini,
_____ a margarita,
_____ a beer (but, not Lite),
_____ a steak,
_____ the remote control,
_____ a bowl of ice cream,
_____ the latest Longhorns’ score
_____ a Kalua on the rocks,
_____ sex,
_____ chocolate
_____ a picture of Angela Jolie/Brad Pitt
_____ a picture of the grandkids

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.

Signature: ___________________________

Date: ____________________________

Witness: ___________________________