Living Wills & Advance Directives

The Tony Bland Case — Why These Documents Matter

The Tony Bland case in 1993 was the first case in English legal history in which the courts allowed a patient to die from the withdrawal of life-prolonging treatment, including food and water. Tony Bland had been in a persistent vegetative state since the Hillsborough disaster in 1989 — nearly four years — before the House of Lords authorized the withdrawal of treatment. Other countries are not necessarily as protective of these rights, and protection varies widely within the United States. We are fortunate to live in Washington State, which has one of the most progressive sets of laws protecting patients' rights regarding their medical treatment and the withdrawal thereof.

What a Living Will Covers

A Living Will — also called a Directive to Physicians or Advance Directive — typically addresses: • Life-sustaining treatment — do you want CPR, mechanical ventilation, or other interventions if there is no reasonable chance of recovery? • Artificial nutrition and hydration — do you want a feeding tube or IV fluids if you are in a persistent vegetative state? • Pain management — do you want aggressive pain relief even if it may hasten death? • Organ and tissue donation — do you wish to donate organs or tissue upon death? • Anatomical gifts — do you wish to donate your body to medical science? Washington's Natural Death Act (RCW 70.122) gives legal effect to these directives and protects healthcare providers who follow them from civil and criminal liability.

Mental & Behavioral Health Advance Directive

A separate Mental/Behavioral Health Including Addiction Advance Directive contains your wishes regarding: • Release of sensitive health care information relating to suicidal depression, alcohol, drug, or gambling addiction • Whether you want to allow your Agent to admit you to inpatient treatment such as addiction rehab or psychiatric suicide prevention hospitalization This document is separate from the standard Living Will because mental health information is subject to heightened privacy protections under both state and federal law (HIPAA and Washington's Mental Health Confidentiality Act). Having this document in place removes ambiguity and protects your agent from liability when making difficult decisions on your behalf.

Living Will vs. Healthcare Power of Attorney — What's the Difference?

These two documents work together but serve different purposes: Living Will — a written statement of your wishes. It speaks for you directly, in your own words, about specific end-of-life scenarios. It is most useful when the situation matches what you described. Healthcare Power of Attorney — names a person (your agent) to make decisions for you. Your agent can respond to situations you didn't anticipate in your Living Will. They can speak with doctors, review records, and advocate for your care in real time. Together, they cover both the situations you planned for and the ones you didn't. Every complete estate plan includes both documents.

Keeping Your Documents Accessible

A Living Will is only useful if it can be found when needed. Best practices: • Give a copy to your healthcare agent, your primary care physician, and any specialists you see regularly • Keep a copy in your home in a known location — not in a safe deposit box, which may be inaccessible in an emergency • Consider registering with a document registry such as DocuBank or MyDirectives, which provide 24/7 access to your documents from anywhere in the world • Carry a wallet card indicating that you have an advance directive and where it can be accessed • Review and re-sign your documents every 5–10 years to confirm your wishes remain current — some healthcare providers are reluctant to honor very old documents