Mississippi Living Will

Home Page Wills  Power of Attorneys  Residents


If at any time you should have an incurable condition certified in writing by your attending physician and one other qualified physician to be  terminal or you have been unconscious, comatose, or otherwise incompetent so as to be unable to make or communicate responsible decisions concerning your person, you may direct that such procedures which would only prolong the dying process be withheld or withdrawn, and that you be permitted to die naturally with only the administration of medication to provide you comfort care.


 Get Living Will

Election of Treatment(s)

After you have completed this form and printed it out, you will be allowed you to check off treatments you want and don't want.  Among those are matters which relate to treatment while you are permanently unconscious and the condition is irreversible.  You will be given the option of receiving artificial nutrition and hydration and other treatment.

Designation of Agent

This living will gives your health care providers or your designated agent (proxy) the power and guidance to make health care decisions according to your wishes when you are in a terminal condition and cannot do so.  This document may include what kind of treatment you want or do not want and under what circumstances you want these decisions to be made. You may state where you want or do not want to receive any treatment. Your agent has the same right as you have to examine your medical records and to consent to their disclosure for purposes related to your health care or insurance unless you limit this right  in this document.

Designation of Physician

This living will allows you to designate a physician to have primary responsibility for your health care.

Operative Date

Your living will becomes operative when a copy is provided to your attending physician; and you are determined by your attending physician to be incompetent and in a terminal condition or in a state of permanent unconsciousness.

Duty of Attending Physician(s)

When your living will becomes operative, your physician and other health care providers shall act in accordance with its provisions.  If your attending physician or other health care provider cannot in good conscience comply with the provisions of your living will or if the policies of the health care provider preclude compliance, your attending physician or health care provider shall so inform you, or, if you are incompetent, shall so inform your agent, or, if you have not designated a health care proxy, shall so inform your family, guardian or other representative.  Your physician and health care provider shall make every reasonable effort to assist in the your transfer to another physician or health care provider who will comply with your living will.


Your living will may be revoked at any time and in any manner by you without regard to your mental or physical condition.  A revocation is effective upon communication to your attending physician or other health care provider by you or a witness to the revocation. 

Ancillary Effect of Executing Living Will

Death resulting from the withholding or withdrawal of life-sustaining treatment does not constitute, for any purpose, a suicide or homicide. The making of a declaration does not affect in any manner the sale, procurement, or issuance of any policy of life insurance, nor does it modify the terms of an existing policy of life insurance.  A policy of life insurance is not legally impaired or invalidated in any manner by the withholding or withdrawal of life sustaining procedures from an insured qualified patient, notwithstanding any term of the policy to the contrary.

Executing and Delivering Your Living Will

After you have completed your living will you should sign it before a notary public OR in front of two witnesses. If you sign in front of two witnesses pay particular attention to the qualifications contained in the witness statement. You should provide a copy of your completed living will to your attending physician and other health care providers and they shall make it a part of your medical records. You should also give a copy to trusted family members.

Source: Mississippi Code 41-41-209; Advance Health Care Directive

Get Living Will