Natural Death Regulations 1984 (SA)
SOUTH AUSTRALIA
being
No. 184 of 1984:
1 Came into operation 30 September 1984: reg. 3.
1. These regulations may be cited as the
Natural Death Regulations, 1984 .2. For the purposes of section 4 of the
Natural Death Act, 1983 a direction shall be in the
form of the Schedule to these regulations.
3. These regulations shall take effect on 30 September, 1984.
TO: The Medical Practitioner responsible for my treatment at such time when I am suffering from a terminal illness*
I, | .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . | declare that I am of sound |
(Name of person making direction)
mind and a person of or above the age of eighteen years AND in the event that I may suffer from a terminal illness* within the meaning of the
DATED | .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . | 19. .. . |
SIGNATURE OF PERSON MAKING DIRECTION | .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . |
WITNESSED in the presence of two witnesses: |
(1). .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . .
(Name, address, occupation)
(2). .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . .
(Name, address, occupation)
*"Terminal illness" means any illness, injury or degeneration of mental or physical faculties:
such that death would, if extraordinary measures were not undertaken, be imminent; | |
and | |
from which there is no reasonable prospect of a temporary or permanent recovery, even if extraordinary measures were undertaken. |
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