I wish to die in peace.
If for any reason I am unable to give explicit informed consent;; 
then in the event of my temporary or permanent disability:
I prohibit all diagnostic and therapeutic intervention
except for sedatives and/or narcotics to relieve dyspnea, pain
and/or mental distress.
I prohibit the administration of fluids by mouth and/or food by mouth
except to relieve manifest thirst and/or hunger.
I prohibit esophageal, tracheal or ureteral intubation.
I prohibit venipuncture for any purpose.
I prohibit intravenous fluids and/or feeding.
I prohibit antibiotic and/or steroid medication for any purpose by any route.

I ask and authorize the person resonsible for my care 
if necessary to protect my right to die in peace
by enforcing compliance with the foregoing prohibitions
in a court of law.


                                    /s/  Ernst Jochen Meyer
                                         174 School St.
                                         Belmont MA 02478            
                                         d.o.b. June 27, 1930
                                         ss no. 097-22-3547