POWER OF ATTORNEY FOR PERSONAL CARE

(The following is a template Power of Attorney for Personal Care intended for use by Canadian cryonicists. The document was originally co-written by Bruce Waugh, a lawyer, and Christine Gaspar, a registered nurse -- of whom are Canadian cryonicists. Further modifications were by Ben Best.)

Whereas I am a member of a CRYONICS organization, and desire to set out directions that are different from most powers,

1. I,  _______________________________  , HEREBY REVOKE any previous power of attorney for personal care made by me and I APPOINT  _______________________________  , to be my attorney for personal care and I declare that this power is a power of attorney for personal care within the meaning of and in accordance with the Substitute Decisions Act, 1992, as amended (the "Substitute Decisions Act").

2. I give to my attorney the AUTHORITY to make any personal care decision for me that I am mentally or physically incapable of making for myself, including without limitation: (i) the giving or refusing of consent to any treatment to which Part II of the Health Care Consent Act, 1996 applies; and (ii) the making of any decision to which Part III and/or Part IV of the Health Care Consent Act, 1996 applies, subject to the Substitute Decisions Act.

3. I direct my attorney that if my recovery is assessed as unlikely, immediate decisions be made towards facilitating a successful cryopreservation, and in particular:

  (a) If I am in a vegetative state, then I want life support to continue unless ALL of the
       following conditions are fulfilled:

     (i)   my recovery is assessed by a physician to be unlikely,

     (ii)  my power of attorney for personal care agrees with this assessment,

     (iii) a cryonics rescue team is on-site and in a state of readiness and,

     (iv)  a qualified physician or nurse is prepared to legally pronounce my
            death immediately after withdrawal of life support

  (b) An autopsy being against my personal belief, no autopsy or invasive procedure shall be performed
       after I have been pronounced dead other than by my cryonics provider or its agents, but if
       an autopsy is legally compelled, my cryonics provider shall be permitted to act in a way
       to minimize brain damage and delay.

Signed this _____  day of  _____________  , 2 ________ .   

 _______________________________ 
 (Signature of Member)

Witness #1: _______________________________ 
                    (Signature of Witness)

                     _______________________________ 
                    (Print Name of Witness)

                     _______________________________ 

                     _______________________________ 
                    (Address of Witness)

Witness #2: _______________________________ 
                    (Signature of Witness)

                     _______________________________ 
                    (Print Name of Witness)

                     _______________________________ 

                     _______________________________ 
                    (Address of Witness)

TO:  _______________________________ 

I have appointed you my attorney under a power of attorney for personal care which I have executed this day and a copy of which is attached hereto.

As my attorney I authorize and instruct you to assume full responsibility for decisions regarding my care and medical treatment if I am unable to look after this myself.

By way of guidance, my wish is , if it is assessed that my recovery is beyond reasonable hope, that all decisions you make should be made towards facilitating a successful cryopreservation as set out in the attached. For example, even if my attending physician has determined that there is no reasonable hope or expectation of my recovering from a terminal medical condition, I am to be kept alive by artificial measures including any modern life support systems (other than procedures that would increase ischemic brain damage) until my cryonics standby team instructs otherwise.

Dated at Toronto, this _____  day of  _____________  , 2 _______ .

Witness #1: _______________________________ 
                    (Signature of Witness)

                     _______________________________ 
                    (Print Name of Witness)

                     _______________________________ 

                     _______________________________ 
                    (Address of Witness)

Witness #2: _______________________________ 
                    (Signature of Witness)

                     _______________________________ 
                    (Print Name of Witness)

                     _______________________________ 

                     _______________________________ 
                    (Address of Witness)

To: My Medical Team

INFORMATION REGARDING MY CRYOPRESERVATION

DATED:  __________________  2 ________ .

 
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