A 77-year-old female is unresponsive, but breathing and with a pulse. on scene, a family member hands you an official document stating that the patient does not want feeding tubes, ventilators, or other long-term life support equipment to keep her alive. there is no mention of whether to administer life-saving drugs or withhold cardiopulmonary resuscitation. the emt would recognize this document as a (n) :
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