SENATE BILL REPORT

ESSB 5401

BYSenate Committee on Human Services & Corrections (originally sponsored by Senators Kreidler, Sellar, Wojahn, McDermott, Bottiger, Zimmerman, Lee, Talmadge, Bluechel, Vognild, Fleming, Bender, Bailey, Garrett, Rinehart, Bauer, Moore, Hansen, Saling and Gaspard)

Changing provisions relating to the natural death act.

Senate Committee on Human Services & Corrections

Senate Hearing Date(s):February 5, 1987; February 11, 1987

Majority Report:  That Substitute Senate Bill No. 5401 be substituted therefor, and the substitute bill do pass.

      Signed by Senators Wojahn, Chairman; Anderson, Deccio, Johnson, Kreidler, Tanner.

Senate Staff:Jean Soliz (786-7755)

                  April 13, 1987

AS PASSED SENATE, MARCH 9, 1987

BACKGROUND:

The Natural Death Act was enacted in 1979 in Washington State. This statute authorizes persons to sign written directives allowing the withholding or withdrawal of life-support procedures which serve only to prolong the moment of death in cases involving a terminal condition.  Life support treatment must not be withheld or withdrawn unless the attending physician determines that the patient has an irreversible terminal condition.  The determination must then be certified by a second physician.

However, the current law makes no provision for withholding or withdrawing life-support treatment in the absence of a written directive.  The Power of Attorney Act makes no specific reference to usage of the act in making health care decisions in cases of incompetency.

SUMMARY:

Specific procedures are established by which a physician may withdraw or withhold life support treatment when the patient has not executed a written directive and is not capable of expressing his or her desires.  A guardian, the holder of a power of attorney, or family members in an order of priority must consent to the withholding or withdrawal of life-sustaining treatment.  If no family members are available, three physicians must certify that the patient is in a terminal condition as defined by the act.

A person in a comatose or vegetative state must otherwise qualify as terminal before life-sustaining treatment may be withheld or withdrawn.  Surgical care, medication, nutrition, and hydration may not be withheld if they are necessary to alleviate pain.  The Natural Death Act shall have no force and effect during the course of a pregnancy.

If any terminally ill hospitalized patient indicates that he or she wishes to die at home and the family concurs, the hospital must discharge the patient immediately.  The hospital and physician shall not be liable for claims arising out of such discharge.

Physicians and health facilities choosing not to comply with a patient's directive are required to transfer the patient to another physician or health facility.  Physicians and health care facilities which choose not to comply are protected from harassment, discrimination or disciplinary action from an employer.

Individuals may execute a power of attorney to authorize others to make health care decisions on their behalf in cases of incompetency.  However, these authorized persons may not consent on the patient's behalf to convulsive treatment, psychosurgery, commitment in mental health facilities or to sterilization.  The durable power of attorney may not be construed to condone, authorize, or approve mercy killing.

Families, health care facilities and health care personnel are immune from liability, unless negligence has occurred.  They are also immune from criminal liability for effectuating the provisions of the chapter in good faith.

Fiscal Note:      none requested

Senate Committee - Testified: Fred Mills, American Association of Retired Persons; Esther Stell, Senior Citizens Lobby; Hilde Birnbaum, Group Health Cooperative Senior Caucus; Dr. Les Nowten, Physicians for Moral Responsibility; Hilke Faber, Nursing Home Residents Council; Kenneth VanDerhoof, Washington State Human Life; Marilyn Derby, National Association of Pro Life Nurses; Steve Milam, Assistant Attorney General for University of Washington; Belding H. Scribner, M.D.. Washington State Medical Association

HOUSE AMENDMENT:

Physicians and facilities which choose not to withhold or withdraw life-sustaining treatment for reasons of conscience are required to locate a physician or facility that will follow the directive of the patient.  The definition of a qualified terminally ill patient includes persons who are in a persistent comatose or vegetative state with no reasonable probability of recovery.  Persons may choose to forego nutrition and hydration in the same way as they may choose not to have life prolonged by any other form of medical care.