Advance Healthcare Directives
Advance healthcare directives answer two questions before anyone has to ask them: who speaks for you when you cannot speak for yourself, and what do you want them to say? Putting clear answers in writing spares your family from guessing, and from disagreeing, during a medical crisis. The Law Office of Chad Foster prepares healthcare directives for clients throughout King and Snohomish Counties.
The Healthcare Directive (Living Will)
Washington's Natural Death Act (Chapter 70.122 RCW) lets any adult sign a healthcare directive, commonly called a living will, stating whether life-sustaining treatment should be withheld or withdrawn if you have a terminal condition or are permanently unconscious. The directive must be signed in the presence of two qualified witnesses, and people with certain conflicts, such as those related to you or entitled to part of your estate, cannot serve as witnesses.
Naming a Healthcare Agent
A directive covers specific end-of-life situations; most medical decisions are not that. A healthcare power of attorney (Chapter 11.125 RCW) names an agent to make the full range of medical decisions whenever you lack capacity, consenting to surgery, choosing among treatments, selecting facilities. The directive tells your agent what you want; the power of attorney gives them the legal authority to make it happen. The two documents are designed to work together.
If You Have Neither: Washington's Default List
If you become incapacitated without naming an agent, Washington law (RCW 7.70.065) supplies a priority list of surrogate decision-makers, beginning with a guardian or named agent, then a spouse or registered domestic partner, adult children, parents, and so on. The default list is a safety net, not a plan: it may select someone you would not have chosen, and when multiple people share a level of priority, treatment can stall while providers wait for them to agree.
Mental Health Advance Directives
Washington also authorizes mental health advance directives (Chapter 71.32 RCW), which let a person state treatment preferences, medications, facilities, who should be notified, that apply during a future behavioral health crisis. For clients managing a mental health condition, this document can preserve self-determination at exactly the moment it is hardest to exercise.
POLST Is Different
Clients often ask about POLST (Portable Orders for Life-Sustaining Treatment). A POLST form is a medical order signed by your physician, physician assistant, or advanced registered nurse practitioner, typically for people who are seriously ill or frail, that travels with you and directs emergency personnel. It complements, but does not replace, a directive and healthcare agent. POLST forms are completed with your medical provider; we make sure your legal documents and your POLST tell the same story.
Our advance directive services include:
- Healthcare directives (living wills) under RCW 70.122
- Healthcare powers of attorney naming and instructing your agent
- Mental health advance directives
- Coordinating directives with your estate plan and long-term care planning
- Updating documents after diagnosis, divorce, or family changes
Common Questions
When do these documents take effect?
Your healthcare agent's authority applies when you lack capacity to make your own decisions, typically determined by your treating providers. The living-will portion applies only in the narrow situations the Natural Death Act covers: a terminal condition or permanent unconsciousness, certified by physicians. While you have capacity, you decide; these documents never override your own voice.
Can I change or revoke my directive?
Yes, at any time while you have capacity, by destroying it, signing a new one, or expressing the revocation. Health care providers honor the most recent valid documents, which is why we recommend dating everything and retrieving superseded copies from your providers and family.
Do doctors have to follow my directive?
Providers are generally required to honor a valid directive or to transfer your care to a provider who will. Conflicts are rare in practice; the far more common problem is the directive nobody can find. Give copies to your agent, your physician, and your hospital system, and keep the originals where your family can reach them.
Can my agent make decisions my family disagrees with?
Yes. That is the point of naming one. A properly appointed agent's decision controls over the preferences of other family members, which prevents deadlock but makes the choice of agent the most important line in the document. Choose the person who will follow your wishes under pressure, not necessarily the oldest child or the closest relative.
Get Started
Estate planning is easiest when it happens before it is urgent. Contact the Law Office of Chad Foster to discuss your situation and put the right documents in place.
Call us at 425.785.8679 or email help@ChadAtLaw.com.