• Washington State Health Care Directives
  • April 13, 2005
  • Law Firm: Perkins Coie LLP - Seattle Office
  • In light of the recent media attention surrounding the Terri Schiavo case there have been increased inquiries and interest in Health Care Directives, sometimes referred to as "living wills." Accordingly, we thought it would be helpful to review the subject of Health Care Directives in the State of Washington.

    The Washington State Legislature has recognized that adults have the legal right to control decisions relating to his or her personal health care, including the decision of whether or not to have life-sustaining treatment withheld or withdrawn if he or she is in a terminal condition or a permanent unconscious condition. The legislature has further recognized the need for a procedure through which adults can assert such right. Washington State allows a resident who is age eighteen or older to make a written directive instructing his or her physicians to withhold or withdraw life-sustaining treatment in the event of a terminal condition or a permanent unconscious condition, commonly referred to as a Health Care Directive. What constitutes a "terminal condition" or a "permanent unconscious condition" is defined statutorily as follows:

    Terminal Condition: an incurable and irreversible condition caused by injury, disease, or illness, that, within reasonable medical judgment, will cause death within a reasonable period of time in accordance with accepted medical standards, and where the application of life-sustaining treatment serves only to prolong the process of dying.

    Permanent Unconscious Condition: an incurable and irreversible condition in which the patient is medically assessed within reasonable medical judgment as having no reasonable probability of recovery from an irreversible coma or a persistent vegetative state.

    In addition to a Health Care Directive, clients should also appoint a representative, through a validly executed Power of Attorney, to act on their behalf in making health care decisions and to assure that the directions set forth in their Health Care Directives are carried out if they are themselves unable to communicate.

    In addition to executing a Health Care Directive, we also recommend that clients discuss their wishes regarding health care with their physicians, the persons appointed under their Power of Attorney and their family members. In discussing health care with physicians, clients may want to discuss completing a Physician Orders for Life-Sustaining Treatment form, commonly referred to as the "POLST form." The POLST form may be executed in addition to, not instead of, a Health Care Directive. The POLST form provides the opportunity to address a variety of situations in more detail regarding the level of treatment a person would like, such as whether or not to use antibiotics or pain-relieving medication under certain circumstances. A person may obtain a POLST form from his or her physician. The physician must also sign the form for it to be valid.