Health Care Directives - “Living Wills”

A Health Care Directive, sometimes called a “Living Will,” states a patient’s wishes regarding medical interventions at the end of life or “heroic measures.” It provides that the patient does not wish for artificial measures if he or she is in a terminal condition, and the measures would only serve to prolong the process of their passing. Similarly, it states that life-sustaining treatments not be applied if the patient is in a “permanent unconscious condition,” such as an irreversible coma. Examples of life-sustaining treatment are ventilators, dialysis, or CPR. In Washington, if a patient doesn’t want artificial nutrition (feeding tubes) or hydration (IV’s), it needs to be stated explicitly in the directive. Even antibiotics can be deemed a life-sustaining treatment where the effect is not to “cure” the patient but rather to prolong the end of life. Our documents make it clear that the patient still wants comfort measures and pain medication. Durable Powers of Attorney regarding health care are related but distinct documents. They appoint an agent to give directions to the doctor when a patient can’t. But the Health Care Directive helps inform the agent’s decisions. Another critical end of life document is a Physician Orders for Life-Sustaining Treatment or “POLST.” This is a bright green form that a doctor provides and reviews with the patient, usually someone who is terminally ill. It includes options for more detailed directives for health interventions, including a “do not resuscitate” order. As the name suggests, it must be signed by the doctor, as well as by the patient or the patient’s agent.