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Washington Health Care Directive
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Washington Health Care Directive

Washington's health care directive runs on the Natural Death Act: two witnesses or a notary, no stated witness age, and no pregnancy clause since July 2025.

By Settled Editorial

A Washington health care directive is the living will authorized by the Natural Death Act, chapter 70.122 RCW. Any adult may sign one, and it directs the withholding or withdrawal of life-sustaining treatment in a terminal condition or a permanent unconscious condition. Sign it in front of two qualified witnesses, or have your signature acknowledged before a notary. Washington asks for one or the other.

Read this page as a planning map for the documents themselves. The wording that fits your health, your family, and your beliefs is a personal decision, and a licensed Washington attorney or your own clinician can confirm a document says what you mean before you sign it.

This guide pairs with the Washington power of attorney guide, because the health care agent is created under a different act with different execution rules, and with the Washington guardianship guide for what a court-appointed guardian can and cannot override.

Washington Splits the Answer Across Four Acts and One EMS Section

Washington did not adopt the Uniform Health-Care Decisions Act. There is no single Washington advance directive statute, and treating the subject as one act is the fastest way to get a Washington answer wrong. Five places carry the law.

  • The living will is the Natural Death Act, chapter 70.122 RCW. The statute calls the document a "directive" and calls the person who signs it the "declarer."
  • The health care agent has no act of its own. The appointment lives inside the Uniform Power of Attorney Act, chapter 11.125 RCW, with the health care rules concentrated at RCW 11.125.400.
  • The default decision-maker for a patient who signed nothing is RCW 7.70.065, which sits in Title 7 beside the medical-malpractice statutes rather than in Title 11 or Title 70.
  • Mental health treatment gets a separate instrument under chapter 71.32 RCW, with its own execution rule and its own witness bar.
  • The portable order paramedics read, POLST, rests on RCW 43.70.480, a Department of Health rulemaking section.

Check the citation before you trust a source. Chapter 11.94 RCW, Washington's old power of attorney chapter and the home of the durable power of attorney for health care most older material names, is wholly repealed. Its disposition page carries the same line for every section: repealed by 2016 c 209 § 504, effective January 1, 2017. The live chapter is 11.125 RCW. The same trap sits under guardianship, where chapters 11.88 and 11.92 RCW are gone and chapter 11.130 RCW replaced them.

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What the Natural Death Act Directive Actually Does

The directive is an instruction document. It appoints nobody. RCW 70.122.030(1) lets any adult person execute a directive directing the withholding or withdrawal of life-sustaining treatment in a terminal condition or a permanent unconscious condition, and the person who carries it out is your attending physician. If you also want someone empowered to speak for you, that takes a second document.

Washington prints a form inside the statute and then declines to require it. The section says the directive "may be in the following form and may include a notarial certificate for an acknowledgment in an individual capacity in short form as permitted by state law, but in addition may include other specific directions." RCW 70.122.020(3) backs that up by defining a directive as a written document "generally consistent with the guidelines of RCW 70.122.030." The printed form is a safe harbor and a template. You may add directions it does not contemplate.

The form runs six lettered paragraphs, and paragraph (c) is the one to read twice. It makes you check one of two boxes:

I DO want to have artificially provided nutrition and hydration.

I DO NOT want to have artificially provided nutrition and hydration.

That election matters because Washington writes tube feeding into the definition. RCW 70.122.020(5) defines life-sustaining treatment as an intervention using mechanical or other artificial means, "including artificially provided nutrition and hydration," that would serve only to prolong the process of dying. The same definition excludes "the administration of medication or the performance of any medical or surgical intervention deemed necessary solely to alleviate pain," so a Washington directive never authorizes withdrawal of comfort care. Leave paragraph (c) blank and you leave the most-contested question in the document unanswered.

Two more provisions round out the document. Paragraph (b) asks any person later appointed to decide, "whether through a durable power of attorney or otherwise," to be guided by the directive. Paragraph (f) is a severability wish, so one invalid line does not take the rest down with it.

Nothing gets filed. A Washington directive is not recorded in any land record and is not filed with a court. RCW 70.122.030(1) sets a medical-record duty instead: the directive or a copy "shall be made part of the patient's medical records retained by the attending physician, a copy of which shall be forwarded by the custodian of the records to the health facility when the withholding or withdrawal of life-support treatment is contemplated."

Once the paper exists, RCW 70.122.120 protects it in a single sentence: "Any person or health facility may assume that a directive complies with this chapter and is valid." A Washington hospital may act on a facially regular directive without auditing how it was signed.

Two Witnesses or a Notary, and Washington States No Witness Age

Here is the rule most cross-state summaries flatten. RCW 70.122.030(1) reads that the directive "shall be signed by the declarer and acknowledged before a notary public or other individual authorized by law to take acknowledgments or signed by the declarer in the presence of two witnesses." That is a genuine alternative. A notarized Washington directive with zero witnesses satisfies the statute, and so does a witnessed directive with no notary. Never write "two witnesses and a notary."

The notarial route is newer than most published Washington material. It arrived with 2019 c 209 s 2, Engrossed House Bill 1175, whose certification of enrollment prints an effective date of July 28, 2019. The proof it is new sits one document back: the 1992 session law that last rewrote this section reads "The directive shall be signed by the declarer in the presence of two witnesses," and the words notary and acknowledgment appear nowhere in it. Guidance written before mid-2019 describes a two-witness-only rule that is no longer the whole story.

If you use witnesses, Washington disqualifies people by interest rather than by age. The section bars:

  • anyone related to you by blood or marriage;
  • anyone who would be entitled to any portion of your estate at your death under any will or codicil then existing;
  • anyone who would be entitled to any portion of your estate at the time of the directive by operation of law then existing;
  • your attending physician;
  • an employee of the attending physician, or of a health facility in which you are a patient; and
  • anyone who has a claim against any portion of your estate at the time the directive is executed.

Read that list against a hospital room. Your spouse is out, your children are out, your intestate heirs are out, the doctor is out, and every nurse on the floor is out. That is the situation the 2019 notarial alternative solves, and it is the reason to reach for a notary rather than to hunt for two acceptable strangers.

Notice what the section does not say. RCW 70.122.030 states no minimum witness age. The disqualifications are relational, testamentary, and employment-based, with no number anywhere. Do not import "witnesses must be 18" from another state, and do not import it from chapter 71.32 RCW, whose mental health directive rule genuinely does say "at least two adults." Age enters the directive only through who may sign it: RCW 70.122.020(1) defines an adult person by the age of majority in RCW 26.28.010, which sets full age at eighteen years, and adds that the signer must have the capacity to make health care decisions.

The witnesses sign under a short attestation printed in the form: "The declarer has been personally known to me or has provided proof of identity and I believe him or her to be capable of making health care decisions."

The Pregnancy Clause Is Gone

Until July 27, 2025, Washington's statutory form carried a paragraph (d) reading: "If I have been diagnosed as pregnant and that diagnosis is known to my physician, this directive shall have no force or effect during the course of my pregnancy."

House Bill 1215, Chapter 56, Laws of 2025, struck it. The bill's own title is "NATURAL DEATH ACT-MODEL DIRECTIVE FORM-REFERENCES TO PREGNANCY," its certification of enrollment prints an effective date of July 27, 2025, and the signed session law shows the sentence inside Washington's double-parenthesis deletion marker with the remaining paragraphs relettered. The current section was read in full on 2026-08-08 and contains no pregnancy provision of any kind.

This is the single most likely stale fact on any Washington advance directive page. The clause survived from 1992 to 2025 and is quoted in a great deal of published material, including form packets still circulating. If a Washington form in front of you prints it, that form predates the amendment.

When the Directive Turns On: One Physician, or Two

A Washington directive does not operate because you are sick. It operates when you become a "qualified patient," and RCW 70.122.020(8) defines that with a physician count that changes by condition:

  • Terminal condition. One physician. You must be "diagnosed in writing to have a terminal condition by the patient's attending physician, who has personally examined the patient."
  • Permanent unconscious condition. Two physicians. You must be "diagnosed in writing to be in a permanent unconscious condition in accordance with accepted medical standards by two physicians, one of whom is the patient's attending physician, and both of whom have personally examined the patient."

Both conditions carry statutory definitions. A terminal condition is an incurable and irreversible condition caused by injury, disease, or illness that within reasonable medical judgment will cause death within a reasonable period of time, where life-sustaining treatment serves only to prolong the process of dying. A permanent unconscious condition is an incurable and irreversible condition with no reasonable probability of recovery from an irreversible coma or a persistent vegetative state.

Who counts as a physician is narrower than you might assume. RCW 70.122.020(7) defines physician as a person licensed under chapter 18.71 or 18.57 RCW, so the Natural Death Act turns on a physician's determination rather than a nurse practitioner's or a physician assistant's. The attending physician is the one selected by, or assigned to, the patient with primary responsibility for treatment and care.

Two paperwork rules follow. RCW 70.122.030(2) requires that the diagnosis be "entered in writing and made a permanent part of the patient's medical records" before treatment is withheld or withdrawn. And RCW 70.122.060(1) makes the attending physician verify the directive complies with RCW 70.122.030 and, "if the patient is capable of making health care decisions," confirm that the directive and the proposed steps match what the patient currently wants. A patient who still has capacity gets asked. The paper does not displace the person.

The document itself does not expire. Chapter 70.122 RCW sets no renewal requirement, and RCW 70.122.040(3) writes in the opposite of an expiry: if the declarer becomes comatose or is rendered incapable of communicating with the attending physician, "the directive shall remain in effect for the duration of the comatose condition or until such time as the declarer's condition renders the declarer able to communicate with the attending physician."

The Health Care Agent Lives Inside the Power of Attorney Act

Washington has no standalone health care proxy act. Naming a decision-maker means signing an ordinary power of attorney under chapter 11.125 RCW that grants general authority over health care matters. RCW 11.125.400 then supplies the defaults: the agent may act as your HIPAA personal representative for all purposes, including accessing your health care information, and may "provide informed consent for health care decisions on the principal's behalf."

Four Washington rules run opposite to what a generic form assumes.

A Washington power of attorney is not durable by default. RCW 11.125.040 provides that authority under a power of attorney, whether created before or after January 1, 2017, "terminates upon the incapacity of the principal unless the writing contains the words 'This power of attorney shall not be affected by disability of the principal,' or 'This power of attorney shall become effective upon the disability of the principal,' or similar words showing the intent of the principal that the authority conferred shall be exercisable notwithstanding the principal's incapacity." Washington enacted the Uniform Power of Attorney Act and declined its durable-by-default rule. A form built on that default does the exact opposite of what its signer wanted.

Coagents act jointly unless you say otherwise. RCW 11.125.110(1): "Unless the power of attorney otherwise provides, all coagents must exercise their authority jointly." Name two children without an either-may-act-alone clause and neither can consent by themselves in an emergency room.

Some people cannot serve. RCW 11.125.400(3) bars any of your physicians, the physicians' employees, and the owners, administrators, or employees of the health care facility or long-term care facility where you reside or receive care. The bar lifts for family: it opens "Unless he or she is the spouse, state registered domestic partner, father or mother, or adult child or brother or sister of the principal." A daughter who works at her mother's nursing home may serve. An unrelated administrator of the same home may not, and the relief list stops at that closed set of relatives.

A newer document does not cancel the older one. RCW 11.125.100(7): "The execution of a power of attorney does not revoke a power of attorney previously executed by the principal unless the subsequent power of attorney provides that the previous power of attorney is revoked or that all other powers of attorney are revoked." Say so in the new one.

The execution rule for the power of attorney is close to the directive's but not identical. RCW 11.125.050(1) requires the principal's signature and a date, then either a notarial acknowledgment or attestation by two or more competent witnesses who are neither home care providers for the principal nor care providers at an adult family home or long-term care facility where the principal resides, and who are unrelated by blood, marriage, or state registered domestic partnership to the principal or the agent. That last phrase catches people. The bar reaches relatives of the person you are appointing, not only your own. And the power of attorney rule disqualifies no heir, beneficiary, or creditor, which the directive rule does. A witness who is fine for one document may be barred from the other, so line up witnesses per document rather than once.

Timing is a choice you make. RCW 11.125.090(1) makes a power of attorney effective when executed unless you provide that it begins at a future date or on a future event. Washington's default is immediate authority, not a springing one. If you do write in an incapacity trigger and name nobody to call it, subsection (3) supplies a default: a physician or licensed psychologist, unrelated to you or the agent by blood or marriage, who has personally examined you, determines in writing that you are incapacitated. Note that a licensed psychologist qualifies here even though the Natural Death Act's trigger is physician-only.

Two hard limits sit on the agent. The health care authority is "subject to the same limitations as those that apply to a guardian under chapter 11.130 RCW," except where you consented in a chapter 71.32 RCW mental health advance directive to inpatient admission or electroconvulsive therapy. And RCW 11.125.420 closes one door outright: "no rights under Washington's death with dignity act, chapter 70.245 RCW, may be exercised through a power of attorney." RCW 7.70.065(1)(d) shuts the same door for a default surrogate. A Washington advance directive cannot request aid in dying on the signer's behalf.

One more trigger to watch. RCW 11.125.100(2)(c) terminates the agent's authority when an action is filed for dissolution, annulment, or legal separation involving the agent, unless the document says otherwise. It is the filing that operates, not the decree, and subsection (3) reinstates the authority immediately if the action is dismissed by consent or withdrawn.

Sign Nothing, and Washington Runs a Ten-Class List

This is the section to read twice, because the answer most people carry in their heads comes from a different state.

RCW 7.70.065(1)(a) ranks ten classes in descending priority for an adult patient who lacks capacity:

  1. The appointed guardian of the patient, if any
  2. The individual to whom the patient has given a durable power of attorney encompassing health care decisions
  3. The patient's spouse or state registered domestic partner
  4. Children of the patient who are at least eighteen years of age
  5. Parents of the patient
  6. Adult brothers and sisters of the patient
  7. Adult grandchildren of the patient who are familiar with the patient
  8. Adult nieces and nephews of the patient who are familiar with the patient
  9. Adult aunts and uncles of the patient who are familiar with the patient
  10. A close friend who meets the conditions below and signs the statutory declaration

Washington's list runs deeper than most. Classes seven through nine each carry the qualifier "who are familiar with the patient," which the earlier classes do not, and a Washington patient with no immediate family still reaches a statutory decision-maker without a guardianship case.

Authority passes down only after work. The provider must make "reasonable efforts to locate and secure authorization from a competent person in the first or succeeding class" and find no such person available. Two rules then sit on top, and both cause real bedside deadlock:

  • A refusal upstairs blocks everyone downstairs. No person may consent "if a person of higher priority under this section has refused to give such authorization."
  • A split class produces nothing. No person may consent "if there are two or more individuals in the same class and the decision is not unanimous among all available members of that class." Three siblings who disagree yield no decision at all, and the next class down does not inherit the question.

The tenth class is the most conditional. The adult must have exhibited special care and concern for the patient, be familiar with the patient's personal values, be reasonably available, and must not be a physician to the patient or that physician's employee, must not be an owner, administrator, or employee of the facility where the patient resides or receives care, and must not be paid to provide care to the patient. On top of that, the friend signs a declaration under penalty of perjury under chapter 5.50 RCW reciting regular contact, familiarity with the patient's activities, health, personal values and morals, willingness to be involved, and the absence of any higher-priority person willing and able to act. That declaration "is effective for up to six months from the date of the declaration."

Read that six-month clock precisely. It attaches to the close friend's declaration, and to the relative's declaration for a minor under subsection (2)(a)(v). Nothing in RCW 7.70.065 puts a time limit on a spouse's, child's, parent's, or agent's authority. Washington does not have a six-month cap on surrogate decision-making.

A provider may rely on that declaration but is not required to, and a provider or facility relying on a compliant one "is immune from suit in any action, civil or criminal, or from professional or other disciplinary action." Going the other way, RCW 7.70.065(5) makes a person who knowingly provides a false declaration "subject to criminal penalties under chapter 9A.72 RCW," Washington's perjury chapter.

Before any of this starts, a capacity finding has to be made and written down. Washington presumes capacity. A person of the age of consent for a particular decision "is presumed to have capacity, unless a health care provider reasonably determines the person lacks capacity to make the health care decision due to the person's demonstrated inability to understand and appreciate the nature and consequences of a health condition, the proposed treatment ... and reach an informed decision as a result of cognitive impairment; and the health care provider documents the basis for the determination in the medical record." Both halves are required. The inability must trace to cognitive impairment, and the basis must be documented.

Whoever ends up deciding uses substituted judgment first. The person "must first determine in good faith that that patient, if he or she had the capacity to make the health care decision, would consent to the proposed health care." Best interests is the fallback, available only when that first determination cannot be made.

Guardian or Agent: Washington Publishes Two Answers

Two current Washington provisions point in opposite directions, and quoting either one alone misleads a reader.

RCW 7.70.065(1)(a) ranks "the appointed guardian of the patient, if any" first and "the individual, if any, to whom the patient has given a durable power of attorney that encompasses the authority to make health care decisions" second in its consent-priority list.

RCW 11.130.335(1) says the opposite thing from the guardianship side: a guardian for an adult "does not have the power to revoke or amend a power of attorney for health care," and "If a power of attorney for health care is in effect, unless there is a court order to the contrary, a health care decision of an agent takes precedence over that of the guardian and the guardian shall cooperate with the agent to the extent feasible." The court keeps authority to revoke or amend the power of attorney itself.

Both are law today, and neither settles the other. The guardian's first-place ranking in RCW 7.70.065 does not decide a contested case, and neither does the agent's precedence in RCW 11.130.335. How a Washington court reconciles the two in a contested case was not established from the statutes read for this page, and it is left open here rather than guessed. Naming an agent is still the move that keeps the question out of court in the first place, which is why the document sits alongside your will on the Washington estate planning checklist.

POLST Is a Clinician Order, Not a Directive

A directive is a plan you write. A POLST is a present medical order signed by a clinician and pointed at other providers and at emergency responders.

Washington's statutory hook is RCW 43.70.480, and it is two sentences long. It directs the Department of Health to "adopt guidelines and protocols for how emergency medical personnel shall respond when summoned to the site of an injury or illness for the treatment of a person who has signed a written directive or durable power of attorney requesting that he or she not receive futile emergency medical treatment," and provides that "The guidelines shall include development of a simple form that shall be used statewide."

The Department describes the relationship plainly on its own page: the POLST form "represents a way of summarizing wishes of an individual regarding life sustaining treatment identified in an advanced directive such as a Health Care Directive or Durable Power of Attorney for Health Care. It is intended to go with the patient from one healthcare setting to another." The page lists what the form covers: patient wishes for resuscitation, medical interventions, antibiotics, and artificial feedings. A POLST summarizes and operationalizes. It replaces neither Washington document.

One sourcing note worth carrying. The form itself is a joint product of the Department and the Washington State Medical Association, and it is published at wsma.org rather than on a Washington state host. This page cites no POLST form number, because a form number has to be read off the printed document at a primary source and none was.

Mental Health Treatment Gets Its Own Document

Chapter 71.32 RCW creates a separate Washington instrument, the mental health advance directive, with its own execution rule and its own witness bar. It may stand alone or sit alongside a power of attorney, so long as each is executed under its own statute.

RCW 71.32.060(1) requires the directive to be in writing, to contain language clearly indicating the principal intends to create one, to be dated and signed by the principal (or at the principal's direction in the principal's presence if the principal is unable to sign), to designate whether the principal wishes to be able to revoke it during any period of incapacity, and to be either acknowledged before a notary or "witnessed in writing by at least two adults." That witness-age line is the only one in Washington's advance directive set, and it does not carry over to RCW 70.122.030 or RCW 11.125.050.

Two features have no analogue in the other two documents. The revocability election at subsection (1)(d) is mandatory, so the signer must choose in advance whether a future incapacitated self can tear the document up. And if the directive appoints an agent under chapter 11.125 RCW, subsection (2) requires the same durability wording the general power of attorney rule demands.

The witness bar at RCW 71.32.090 lists six disqualifications, including one found nowhere else in this area of Washington law: a person who would benefit financially if the principal undergoes mental health treatment may not witness.

Revoking a Washington Directive

RCW 70.122.040(1) opens with a rule most states do not write: "A directive may be revoked at any time by the declarer, without regard to the declarer's mental state or competency." Losing capacity does not lock a Washington declarer into a document. Four methods follow.

  1. Destroy it. By being "canceled, defaced, obliterated, burned, torn, or otherwise destroyed by the declarer or by some person in the declarer's presence and by the declarer's direction." Effective on the act.
  2. Sign a written revocation. Signed and dated by the declarer, expressing the intent to revoke. It "shall become effective only upon communication to the attending physician," and the physician records the time and date of notification in the medical record.
  3. Say so out loud. A verbal expression of intent to revoke, again effective only on communication to the attending physician, who records the time, date, and place of the revocation and of the notification if different.
  4. Use the registry method. For a directive stored in the registry under RCW 70.122.130, by an online method established by the Department of Health. Failure to use it "does not invalidate a revocation that is made by another method described under this section."

Routes two and three share one trap worth naming. Telling your daughter, your nurse, or your lawyer is not the statutory trigger. The clock starts when the attending physician is told. And subsection (2) protects everyone else: there is no criminal or civil liability for failing to act on a revocation unless the person has actual or constructive knowledge of it.

The State Registry Exists in Statute. Its Operation Is Unconfirmed.

RCW 70.122.130(1) orders the Department of Health to "establish and maintain a statewide health care declarations registry" and to digitally reproduce and store declarations in it. Subsection (2)(a) lets an individual submit four document types: a Natural Death Act directive, a durable power of attorney for health care under chapter 11.125 RCW, a mental health advance directive under chapter 71.32 RCW, or a form adopted under the Department's RCW 43.70.480 authority.

The part a planner needs is subsections (2)(b) through (d), and Washington is unusually blunt about it. Failure to submit a declaration does not affect its validity. Failure to notify the Department of a valid revocation does not affect the validity of the revocation. And entry of a directive in the registry does not affect the validity of the document, does not take the place of any requirement in law necessary to make it legal, and does not create a presumption about its validity. RCW 70.122.051(3) closes the loop from the provider side: "The establishment of a health care declarations registry does not create any new or distinct obligation for a provider to determine whether a patient has a health care declaration."

Whether the registry is operating today could not be confirmed at an official source. A sweep of all 3,790 URLs in the Department of Health sitemap on 2026-08-07 and again on 2026-08-08 returned no advance directive or declarations registry page, and the WAC Title 246 chapter list carries no chapter implementing RCW 70.122.130. That is evidence of absence, not proof of discontinuation, so this page records the statutory mandate as fact and leaves the operational status open. Do not treat registration as a step that makes a Washington directive work. Hand copies to your agent, your alternate, and your primary care practice, and ask your own provider what they can retrieve from their record system.

What a Washington Provider Must Do, and What It May Refuse

Chapter 70.122 RCW gives providers a set of duties and protections that most Washington readers never see.

Conscience objection runs both ways. RCW 70.122.060(4): "No nurse, physician, or other health care practitioner may be required by law or contract in any circumstances to participate in the withholding or withdrawal of life-sustaining treatment if such person objects to so doing." The same subsection forbids discrimination in employment or professional privileges for either participating or refusing. Washington attaches no duty on the objecting individual to transfer your care.

Institutions owe disclosure and a written plan. RCW 70.122.060(2) is Washington's distinctive answer, and it is a disclosure rule rather than a transfer rule. The attending physician or health facility must tell you or your representative about any policy or practice that would preclude honoring your directive, as soon as they learn the directive exists. If you then choose to stay with that physician or facility, the two of you prepare a written plan, filed with the directive, setting out what they intend to do should your medical status change so the directive would operate. Having complied, including with that plan, the physician or facility "has no obligation to honor the patient's directive." A Washington patient can knowingly stay with a provider who will not follow the document, and the statute turns that into a documented choice.

The directive is conclusive unless revoked. RCW 70.122.060(3): "The directive shall be conclusively presumed, unless revoked, to be the directions of the patient regarding the withholding or withdrawal of life-sustaining treatment."

Good-faith participation is immune. RCW 70.122.051(2) immunizes a provider who participates in good faith in withholding or withdrawing life-sustaining treatment in accordance with the chapter from civil, criminal, and professional-conduct liability, "unless otherwise negligent."

Interference is a crime. RCW 70.122.090(1) makes willfully concealing, canceling, defacing, obliterating, or damaging another's directive without consent a gross misdemeanor. Subsection (2) reaches further: forging another's directive, or willfully concealing a revocation with intent, where the act "directly causes life-sustaining treatment to be withheld or withdrawn and death to thereby be hastened," is "subject to prosecution for murder in the first degree as defined in RCW 9A.32.030." Watch the causal chain there. Forgery alone is not that offense.

Insurance cannot be touched, and this is not a suicide. RCW 70.122.070(1) provides that withholding or withdrawing life-sustaining treatment under a directive "shall not, for any purpose, constitute a suicide or a homicide." Subsection (2) protects life insurance both at issue and after the fact, "notwithstanding any term of the policy to the contrary." Subsection (3) bars any provider, health care service plan, disability insurer, self-insured employee welfare benefit plan, or nonprofit hospital service plan from requiring anyone to sign a directive as a condition of coverage or care.

You may go home to die. RCW 70.122.110 is a rare provision: "If a qualified patient capable of making health care decisions indicates that he or she wishes to die at home, the patient shall be discharged as soon as reasonably possible." The provider must explain the medical risks of an immediate discharge, and having done so carries no civil or criminal liability for claims arising from it.

Two closing rules of construction. RCW 70.122.910 says the chapter is not "the exclusive means by which individuals may make decisions regarding their health treatment," and does not limit routes case law provides. RCW 70.122.925 applies the chapter's spouse, marriage, widow, next of kin, and family language equally to state registered domestic partnerships. An out-of-state directive gets a qualified welcome rather than a flat one: RCW 70.122.030(3) says a directive executed in another political jurisdiction "is valid to the extent permitted by Washington state law and federal constitutional law." The power of attorney rule is more generous, so a person who moved to Washington should look at both documents separately.

What This Means for Your Washington Documents

Here is the order that avoids the traps above.

  1. Sign both documents, not one. The Natural Death Act directive states your treatment wishes. The chapter 11.125 RCW power of attorney names the person who speaks. Neither does the other's job.
  2. Put the durability words in the power of attorney. Without the RCW 11.125.040 language, the agent's authority ends at your incapacity. Confirm the phrase is on the page before you sign.
  3. Answer the nutrition and hydration box. Paragraph (c) of the statutory form is a check-one election, and Washington counts tube feeding as life-sustaining treatment.
  4. Pick the notary route if you are in a hospital or a nursing home. The directive's witness bar rules out family, heirs, your doctor, and facility employees, and RCW 70.122.030 has allowed a notarial acknowledgment instead since July 28, 2019.
  5. Line up witnesses per document. The directive bars relatives and heirs. The power of attorney bars care providers and relatives of the principal or the agent. One person can be fine for one document and barred from the other.
  6. Say in the new power of attorney that it revokes the old one. RCW 11.125.100(7) leaves prior documents alive otherwise.
  7. Deliver copies rather than relying on a registry. Your agent, your alternate, and your primary care practice each need one. Registration never affects validity, and no Washington provider is obliged to look for one.
  8. Check the paper you were handed for the pregnancy clause. If it is there, the form predates July 27, 2025 and should be replaced.
  9. Review after a move, a divorce filing, a diagnosis, or a death in the family. A dissolution filing terminates an agent spouse's authority on its own under RCW 11.125.100(2)(c).

Next steps for the rest of the plan: the financial side of incapacity planning sits in the Washington power of attorney document, the Washington guardianship guide covers what happens when nobody signed anything, and the Washington probate guide explains what the estate faces after a death.

Sources:

It is not legal advice.

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Settled Estate is not a law firm and does not give legal advice.

Information current as of August 8, 2026

Settled Estate is not a law firm, and this content is for informational purposes only and does not constitute legal advice. Probate laws and procedures in Washington can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.

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