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FAQ

Frequently Asked Questions

Questions about why you need an advance directive

  1. What happens if I get too sick or incapacitated that I cannot say what I want for my own health care?
  2. If my family and friends all know my wishes if I get seriously ill, why do I need to fill out an advance directive?
  3. How is it determined that I am too sick or incapacitated to make my own health care decisions?
  4. Do I have to identify a health care agent?
  5. What if I do not have anyone to designate as a health care agent?
  6. What happens if I change my mind about what I want after I have completed the advance directive form?

Questions on completing advance care planning forms

  1. Are the forms I fill out required to have a notary signature?
  2. Who can be my witnesses for the advance directive form?
  3. Can I have the hospital or doctor office witness or notarize my advance directives?
  4. Do I need to have an attorney prepare these forms for me?
  5. Will my advance directive and wishes be honored if I go out of state?
  6. Do advance directives take into account different cultures, beliefs and what is important to me?

The forms are completed, now what?

  1. How do I store my forms? Do they need to be in a locked, safe place? Is there a statewide or national registry where my documents can be stored online?
  2. How long is an advance directive good for? Does it need to be updated?
  3. Are health care professionals required to follow my instructions in the advance directive?
  4. Are there situations when my advance directive and wishes may not be followed?
  5. What happens to a health care provider(s) if they knowingly do not follow my wishes for end of life care and do not tell me or my health care agent ahead of time?
  6. What makes an advance directive legal?

Questions about the other health care forms you may have heard about

  1. What is the difference between a living will and an advance directive?
  2. What is the difference between an advance directive and a durable power of attorney for health care?
  3. What is the difference between a durable power of attorney for health and a health care surrogate, health care proxy or health care agent?
  4. What is the difference between an advance directive and advance care planning?
  5. What is the difference between a POLST and advance directive forms?

Questions about life-sustaining treatment and end-of-life care

  1. If I am diagnosed with a serious illness, or if I am in a long-term care facility and get sick, do I need to go to the hospital? What are my options?
  2. Can doctors just keep providing treatment, even if it seems like I won’t get better?
  3. What if I have a temporary condition that turns to long-term illness? Such as I go in for a routine outpatient procedure and have a severe adverse outcome, rendering me incapacitated. When does my advance directive kick-in?
  4. What does DNR stand for?
  5. I have an advance directive that clearly states I do not want (Cardiopulmonary Resuscitation) CPR, if an ambulance is called will they still perform CPR?
  6. Does CPR always work?
  7. Do artificial hydration and nutrition allow people to live longer than without?

Additional questions or information

  1. What is National Health Care Decisions Day?
  2. What is a Death Café?
  3. What is the Death with Dignity Act?
  4. Read Honoring Choices Pacific Northwest Privacy Policy.

Questions about why you need an advance directive


1. What
happens if I get too sick or incapacitated that I cannot say what I want for my own health care?

Preparing for this by naming a health care agent – and preparing an advance directive – will set forth your predetermined intentions for your own treatment in the event of your incapacitation, or if you are otherwise unable to direct your health care treatment.

2. If my family and friends all know my wishes if I get seriously ill, why do I need to fill out an advance directive?

Ensuring that your loved ones know your wishes through conversations is an excellent start to making sure the care you want is known. It is not required that you complete an advanced directive, but it is highly recommended so that you can identify a health care agent to speak for you and who knows your wishes for your own care.

Once you learn and understand your options, you can write down what is important to you and fill out an advance directive in case you become incapacitated, fall seriously ill, or are otherwise unable to speak for yourself.

3. How is it determined that I am too sick or incapacitated to make my own health care decisions?

Under Washington law, your advance directive will take effect either of the following occur:

    • Your attending physician must make a written diagnosis that you are in a terminal condition where treatment would only artificially prolong the process of dying;

      OR

    • Two physicians must make a written diagnosis that you are in a permanent unconscious condition.

4. Do I have to identify a health care agent?

While it is not required, it is highly recommended you name someone who is close to you, and who knows your wishes, as your health care agent. You get to choose who this person will be, and it is important to name your health care agent in writing.

In the event you become incapacitated and no one is selected, the Washington default structure will take effect.

5. What if I do not have anyone to designate as a health care agent?

Washington’s legal protocol regarding the selection of others to make health care decisions on your behalf, in order of priority, is:

I.         A guardian with health care decision-making authority, if one has been appointed;
II.        The agent named with health care decision-making authority;
III.       Your spouse;
IV.       Your adult children;
V.       Your parents;
VI.       Your adult brothers and sisters.

It is always best to name an agent of your choosing to make health care decisions on your behalf, in order avoid any issues and/or complications that may come up in relying on the legal protocol.

6. What happens if I change my mind about what I want after I have completed the advance directive form?

You can change your mind at any time and update or revoke your documents. This is always about what you want. The important thing to remember is to give your updated form to those who have access to your previous advance directives.

Questions on completing advance care planning forms

1. Are the forms I fill out required to have a notary signature?

There is no requirement of notarization for an advance directive or a power of attorney. However, you must sign your advance directive in the presence of two witnesses. You may wish to have your documents notarized in the event you need to use them in another state.

2. Who can be my witnesses for the advance directive form?

Your two witnesses must certify that they are not related to you by blood or marriage, and are not entitled to any portion of, or any claim to, your estate. 

3. Can I have the hospital or doctor office witness or notarize my advance directives?

Your hospitals and doctors cannot act as witnesses for your advance directives.

4. Do I need to have an attorney prepare these forms for me?

There is no requirement that an attorney prepare these forms for you. However, you may wish to contact an attorney with any specific questions or concerns you may have.

5. Will my advance directive and wishes be honored if I go out of state?

All 50 states (and the District of Columbia) generally recognize the use of advance directives, and there are state and federal laws regarding advance directives. However, you should check the law regarding any specific state you may travel to.

You may want to travel with copies of your health care documents in the event it is needed and the state you are in will honor your wishes.

6. Do advance directives take into account different cultures, beliefs and what is important to me?

Yes, these are your wishes, so we encourage that culture, beliefs and values play an important role in determining what you would want for end-of-life care.

The forms are completed, now what?  

1. How do I store my forms? Do they need to be in a locked, safe place? Is there a statewide or national registry where my documents can be stored online?

Once fully executed, your forms are legal documents and should be treated as such. A copy of your forms should be stored in a safe place. Copies should be made a part of your medical record and provided to your health care agent (including any alternates) and your personal attorney. Finally, copies should be given to someone you trust to provide them in case of an emergency.

The Washington State Department of Health’s Living Will Registry has been eliminated due to budget cuts; however, those seeking to register their health care declarations are being directed to the U.S. Living Will Registry at www.uslivingwillregistry.com.   

2. How long is an advance directive good for? Does it need to be updated?

Your advanced directive is valid unless it is revoked. It is always a good idea to regularly review any directives or power of attorney and ensure that they reflect your current wishes and desires.   

3. Are health care professionals required to follow my instructions in the advance directive?

In the event that your advance directive takes effect, your attending physician must make efforts to ensure that your treatment complies with your wishes and desires.   

4. Are there situations when my advance directive and wishes may not be followed?

Yes.

Your attending physician and/or treating facility must inform you of any known reason that would prevent them from honoring your advance directive and wishes. You always have the right to change physicians and/or facilities. If you elect not to make a change, an alternate plan of treatment must be prepared and filed with your directive.

If the health care provider objects to withholding or withdrawing life-sustaining treatment, they are not required to follow through with withholding and withdrawing treatment.  

5. What happens to a health care provider(s) if they knowingly do not follow my wishes for end of life care and do not tell me or my health care agent ahead of time?

There are state and federal laws in place regarding advanced directives, including a requirement for most facilities to maintain and provide policies and procedures regarding the implementation of advance directives. A provider or facility who violates these laws may be subject to applicable criminal and civil penalties.   

6. What makes an advance directive legal?

The Washington State authority for an individual to control health care decisions through an advance directive is found in the Natural Death Act, located in chapter 70.122 of the Revised Code of Washington.

Questions about the other health care forms you may have heard about   

1. What is the difference between a living will and an advance directive?

A living will is a part of an advance directive. Read more about living wills and advance directives.   

2. What is the difference between an advance directive and a durable power of attorney for health care?

A durable power of attorney for health care names an agent to make health care decisions on your behalf. An advanced directive addresses end of life care and treatment.   

3. What is the difference between a durable power of attorney for health and a health care surrogate, health care proxy or health care agent?

These basically all mean the same. It is someone who you have personally appointed to act on your behalf when you do not want to, or cannot, make decisions for yourself.   

4. What is the difference between an advance directive and advance care planning?

Advance care planning includes the completion of an advance directive.   

5. What is the difference between a POLST and advance directive forms?

A POLST (Physician Order for Life Sustaining Treatment) is intended for any individual with a serious illness and accomplishes two major purposes: It is portable from one care setting to another and it translates wishes of an individual into actual physician order. An advance directive provides information on your wishes regarding life-sustaining treatment and end of life care.

Questions about life-sustaining treatment and end-of-life care

1. If I am diagnosed with a serious illness, or if I am in a long-term care facility and get sick, do I need to go to the hospital? What are my options?

You have the right to direct your treatment, including the refusal of treatment. If you are receiving treatment for a serious or terminal condition, you can request to be discharged and can decide to spend your time at home. Your health care provider has a duty to explain any risks of an immediate discharge, but must otherwise comply with your decision.

2. Can doctors just keep providing treatment, even if it seems like I won’t get better?

A provider has a general duty to provide treatment that provides medical benefit to a patient.

You should discuss any specific questions you have about the possible continuance/discontinuance of treatment with your treating physician.

3. What if I have a temporary condition that turns to long-term illness? Such as I go in for a routine outpatient procedure and have a severe adverse outcome, rendering me incapacitated. When does my advance directive kick-in?

Your advance directive will take effect if you are in a terminal condition and cannot speak for yourself, OR, you are in a permanent unconscious condition.

It is important to have your advance directive and health care agent in place and set out your own predetermined intentions for your treatment, in the event that this unfortunate scenario were to occur.

4. What does DNR stand for?

“Do Not Resuscitate”

A DNR Form is prepared in advance by a patient and physician in the event that the patient experiences cardiac or respiratory failure. This DNR Form directs whether CPR is (or is not) to be attempted.

5. I have an advance directive that clearly states I do not want (Cardiopulmonary Resuscitation) CPR, if an ambulance is called will they still perform CPR?

An emergency care provider will most likely follow their training and attempt live-saving treatment.

A provider must have knowledge of your advance directive and wishes, and it is always best to make your desires for treatment known to any possible providers and any friends or family who may be present when care will be provided.

6. Does CPR always work?

CPR, when combined with proper defibrillation and/or advanced life support, dramatically increases the chance of survival after cardiac or respiratory failure, but does not have a 100% success rate.

You should discuss the effects of CPR with your physician.

7. Do artificial hydration and nutrition allow people to live longer than without?

“Artificial hydration and nutrition” generally refers to any type of life-sustaining treatment, which may be provided for a variety of conditions.   Some types of artificial hydration and nutrition can be provided for long-term periods, and may sustain the life of a patient who would otherwise be unable to eat or drink.  

Additional questions or information

1. What is National Health Care Decisions Day?

National Healthcare Decisions Day is held each year on April 16th, and seeks to educate the public and health care providers about the importance of advance care planning.

Additional information can be found at http://www.nhdd.org

2. What is a Death Café?

A “Death Café” is a general name given to an organized meeting where attendees gather to discuss topics related to death, which may include discussions about loved ones who have passed away, life experiences, and individual issues and concerns. These meetings are usually organized with the intent of fostering discussion to increase awareness and help prepare for the various components of the end of life.

These gatherings are independently organized and, if you are interested in attending, please research if any are offered in your area and the topics that may be discussed. 

3. What is the Death With Dignity Act?

Please visit the Washington State Department of Health’s website for information about the Death with Dignity Act.

4. Read Honoring Choices Pacific Northwest Privacy Policy.