SENATE BILL REPORT

SB 6652

BYSenators Kreidler, Deccio, Wojahn, Lee, Niemi and Sellar

Revising provisions on life-sustaining treatment.

Senate Committee on Health Care & Corrections

Senate Hearing Date(s):February 2, 1988

Senate Staff:Jean Soliz (786-7755)

AS OF FEBRUARY 2, 1988

BACKGROUND:

The Natural Death Act was enacted in 1979 in Washington. 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  Life support treatment must not be withheld or withdrawn unless the attending physician determines that the patient has an irreversible terminal condition.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 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.

Numerous Washington Supreme Court cases have issued since the statute was passed in 1979.  Those decisions have clarified the right of withholding or withdrawing life-sustaining treatment from terminally ill persons who cannot express their desires, but the statutes have not been amended to specify procedures for those situations.

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.

Life sustaining treatment may be withheld or withdrawn from a qualified patient who is incapable of expressing his or her wishes if it is determined, within reasonable medical judgment, by the attending physician that the patient is in a terminal condition.  Authorization must first be obtained by a guardian, a person holding a durable power of attorney, or family members in a stated order of priority.

The definition of a terminal condition is expanded to include persons who are in a comatose or persistent vegetative state with no reasonable probability of recovery, and persons who are in an advanced state of a terminal and incurable illness and are suffering permanent deterioration.

Family members and other decisionmakers, like physicians, are immune from liability for good faith decisions made in accordance with the act.  Physicians who choose not to follow a patient's directive may not be penalized because of their choice, but the health care provider must immediately take steps to transfer the patient to another physician or provider who will follow the patient's directive.

Appropriation:    none

Revenue:    none

Fiscal Note:      none requested

Effective Date:July 1, 1988