Live in Oregon? This article covers the Oregon version.
This article helps you think through your health care wishes before you answer the questions about them. It is written for Washington residents.
Filling in your questionnaire now? See the help for the health care questions. For choosing the person who makes decisions for you, see this article.
Your two Washington health care documents
In Washington, your health care wishes usually go in two documents. Each one does a different job.
Health Care Power of Attorney
This names your health care agent, the person who speaks for you when you cannot speak for yourself. It covers every kind of medical decision, from routine surgery to life support. As long as you can make your own decisions, you make them.
Health Care Directive
This is often called a living will. It tells your doctors, in your own words, whether you want life support continued or withdrawn. It applies only in two situations:
- Your doctor certifies in writing that you have a terminal condition.
- Two doctors confirm that you are permanently unconscious.
Outside those two situations, your agent decides, guided by what you have told them. That is why the questionnaire asks how closely your agent should follow your written wishes.
Life support
Life support means treatment that keeps you alive when your body cannot do it on its own. Examples are CPR to restart your heart, a breathing machine, and tube feeding.
The questionnaire asks: If you are unlikely to survive without life support, what is your preference?
- I would like life support to be continued: You want treatment that keeps you alive, even when recovery is unlikely.
- I would like life support to be withdrawn: You want life support stopped and your care focused on comfort.
- I’m unsure and would like to discuss my options: You want to talk it through with your attorney first.
Your own experience often shapes your answer. Maybe you sat with a parent in intensive care, or your faith guides you. It is fine to be unsure and to want to talk it through with your attorney.
One more question covers pregnancy. If you were pregnant when life support decisions came up, would you want your agent to decide instead of following your Health Care Directive?
How closely your agent follows your wishes
The questionnaire asks: How closely should your Health Care Agent follow your written wishes?
- My agent should strictly follow my stated preferences: Your written wishes are firm instructions.
- My agent should use my wishes as guidance, but may ultimately decide: Your agent weighs your wishes but can adapt.
Think about the person you are naming. Firm instructions spare them from making the hardest call alone. Guidance trusts them to adapt if something happens that you never imagined, such as a new treatment.
Where you would like to receive care
If you ever need long-term or end-of-life care, where would you want to be? The questionnaire offers three answers:
- I’d prefer care at home: You want to stay home if you can.
- I’d prefer care in a hospital or other facility: You would rather be where full-time care is on hand.
- I’m unsure, my Health Care Agent can decide what’s best: You leave the choice to the person you name.
Staying home often depends on family help and paid caregivers, which can be costly. Even so, saying what you would prefer helps the person you name. If they are ever called on to act, they will know what matters to you.
Mental health care
The questionnaire asks whether your agent may make decisions about psychiatric care for you, if you ever need it.
That permission has a limit. Your agent cannot admit you for inpatient mental health treatment over your objection. That takes a separate document, a Mental Health Advance Directive, signed while you are well.
A Mental Health Advance Directive can also record your treatment preferences, such as medications that have worked for you. It can name someone for mental health decisions, too. If this may matter for you, ask your attorney about one.
Dementia
The questionnaire lets you flag possible future dementia as something to discuss with your attorney.
Dementia is different from a sudden illness. It can last for years, and what you would want may differ from one stage to the next. For example, you might want full treatment while you still know your family, but comfort care only once you no longer recognize them.
Others think about where they would want to live, and whether a trip to the hospital would help them or only frighten them. Your attorney can talk with you about writing dementia wishes into your documents.
Organ and body donation
The questionnaire asks whether you are, or would like to be, an organ donor. If you are unsure, you can leave it to your agent. You may already be registered, for example when you got your driver license.
You can also flag two topics to discuss: limits on which organs you would give, and donating your whole body to medical research. Medical schools that accept bodies have their own forms, so that takes planning ahead.
After your death, your agent can act on your organ donation wishes. Telling them now spares your family from guessing at a hard moment.
Health conditions and beliefs
If you live with a serious health condition, you can flag it to discuss with your attorney. It also helps to ask your doctor what lies ahead, and what treatment can and cannot do.
You can also flag religious or spiritual beliefs that should guide your care. You might want a visit from clergy, certain rituals, or limits on some treatments. Flagging them is enough to start the conversation.
POLST: medical orders for serious illness
A POLST form is not a legal document like the others. It is a medical order you fill out with your doctor, usually when you are seriously ill. It tells an ambulance crew right away whether you want CPR and other treatments.
Your legal documents speak for you through the person you name. A POLST speaks for you directly in an emergency, before anyone can reach your agent.
Keep your POLST where responders will see it, such as on your refrigerator.
Death with Dignity
Washington’s Death with Dignity Act lets a terminally ill adult ask for medication to end their life. The request must come from you, while you can still make it. Your agent cannot ask for you, and no health care document can.
Practical tips
- Talk with the person you name and with your doctor. A short conversation now makes their decisions much easier later.
- Tell them where your documents are, and give copies to your doctor, any care facility, and close family. A document no one can find cannot help you.
- Look at your documents again when your health changes. They do not expire, but your wishes might change.
- Before you move into a care facility, ask whether its policies limit any of your wishes. Some facilities will not honor every choice.
- If your spouse or registered domestic partner is your agent, filing for divorce or legal separation ends their authority. That is the rule unless your document says otherwise.
Want to read more?
These articles are optional.
- Choosing the person who decides for you: What to look for, and what happens if you name no one. See this article.
- Final arrangements: Planning for after your death. See this article.
- Glossary: Common estate planning terms. See this article.