Provides that in any judicial proceeding under chapter 26.44 RCW (abuse of children) or chapter 13.34 RCW (juvenile court act) in which it is alleged that a child is at substantial risk of death because of a parent or guardian's refusal to consent to available lifesaving medical treatment for the child, the court shall appoint a guardian ad litem for the child.

Requires an administrator of a hospital or similar institution or certain physicians, who have knowledge of a parent or guardian's refusal to consent to available lifesaving medical treatment for a minor and such refusal creates a substantial risk of death to the minor, to notify the department of social and health services child protective services staff at the earliest opportunity.

Requires the department of social and health services, if notified as required above, to investigate the referral according to policies and timelines for urgent cases.