SENATE BILL REPORT

SB 5401

BYSenators 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)

                  February 12, 1987

AS REPORTED BY COMMITTEE ON HUMAN SERVICES & CORRECTIONS, FEBRUARY 11, 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  Life support treatment must not be withheld or withdrawn unless the attending physician determines that the patient has an irreversible terminal condition.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.

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 which will comply.  The physicians and facilities who choose not to comply with a patient's directive 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 (except through the Involuntary Treatment Act) or to sterilization.  The durable power of attorney may not be construed to condone, authorize, or approve mercy-killing.

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

EFFECT OF PROPOSED SUBSTITUTE:

Nutrition and hydration may not be withheld if the withholding would interfere with the comfort of the patient.  Physicians and health facilities must transfer a patient who has executed a natural death directive, if they cannot follow the directive for reasons of conscience.  The physician or facility does not have to ascertain that the new facility or physician will carry out the directive before transferring.  A person in a comatose or persistent vegetative state must qualify as "terminal" before life-sustaining treatment is withdrawn or withheld.  Surgical care or medication cannot be withheld if they are necessary to alleviate pain.  Family members are granted the same immunity from liability as physicians and health care facilities.

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