Washington Living Will Declaration Form

Creating a living will in Washington allows patients to advise medical practitioners of their preferences for the last medical care they will receive before death. If a patient is unable to make choices for themselves, a living will be used to protect their interests. When a patient's condition is terminal, this form is often used to assess whether or not the patient wishes to receive life-sustaining care.

Washington living will

Washington Living Will Declaration Form

Laws and statutes to adhere to for the Washington living will

Requirements needed to complete the signing process- According to RCW 70.122.030(1), two (2) witnesses or notary public are required to sign the document.

Statutes-Chapter 70.122 of the Revised Statutes of the State of Washington (Natural Death Act)

How and what to put into writing for the Washington living will

Washington Declarant

(1) Imputing your full name- Those who are diagnosed with prolonged unconsciousness or who must undergo an end-of-life procedure because there are no viable therapeutic options are given some control by the state of Washington. Please complete the title of this directive with your name.

In Washington, many are refusing treatment.

(2) Nutritional Supplements. When patients in Washington are unable to eat, there is a significant probability that they may acquire acute malnutrition symptoms. Medical technology will be used by physicians in Washington to deliver the nutrition that their patients need to survive to avoid this. Sign your name in the first item of Article 1 to inform Washington Doctors that you would find artificial sustenance unpleasant and that you would not approve of its distribution.

(3) The use of artificial hydration- The same choice must be taken if you want to directly ingest water or other liquids into your bloodstream. If you don't wish to be artificially hydrated, you may include your initials for the second item on the checklist.

(4) Man-made Respiration-  If your airway is irritated or clogged, for example, you should seek medical attention. In Washington state, patients who submit their initials to the third list item may be alerted that they do not want a breathing machine used to prolong their life, but rather to cure their terminal illness or to bring them back to consciousness after an extended period of unconsciousness.

(5) Cardiopulmonary Resuscitation (CPR)-  If the fourth item on the list is not initialed, you will be given cardiopulmonary resuscitation (CPR) by Washington Doctors. CPR will be administered if you are chronically unconscious or on the verge of death owing to heart failure, as indicated on the list. For Washington Doctors to be aware that you are not in agreement with cardiac resuscitation, you must initial the fourth item on the checklist.

(6) Surgical procedures are performed. Patients in a long-term vegetative state and those with terminal illnesses may not be able to communicate with their doctors about whether or not they want surgery performed on them. When signing the fifth statement, you must include your initials if you do not want to undergo any procedure that does not immediately result in a cure or recovery but just serves to extend your life.

(7) Blood dialysis is an alternative for those who need it. You may choose to leave the sixth statement blank in order to enable blood dialysis to be used to treat your kidneys (if necessary). Initial the "Blood Dialysis" statement if you do not want blood dialysis supplied only for the purpose of prolonging your life after being rendered immobile by an incurable life-threatening medical ailment or a coma.

(8) Transfusion of blood. If you do not believe that participating in blood transfusions will benefit your recovery, you may opt-out of the program. Begin with the sixth claim to express your dissatisfaction with this treatment.

 (9) Prescription drugs. If you do not want Washington Physicians to provide medicine to you if you are dying or if your condition is life-threatening, please initial the eighth phrase. To be clear, this does not cover prescription pain relievers. The topic of pain medication will be covered in more depth later in this essay.

10) Any kind of medical treatment you may need. To avoid having medical procedures that will only let you live longer, you must sign the final statement before they may proceed.

Pain Management Recommendations for Patients

(11) Treatment that has a soothing impact on the patient- Patients suffering from incurable medical illnesses may endure excruciating agony from time to time. According to Article 5 of this proclamation, the main objective of therapy for persons who are terminally ill, reaching the end of their life, or suffering from an incurable medical condition should be the relief of pain. So even if pain management practices and drugs have the potential to reduce your life expectancy, they will still be provided. However, it is highly advised that you consult with a Washington Physician about any medical conditions you may be experiencing and their treatment before altering or eliminating this part from your document (or signing this paperwork).

Directive on Pregnancy

(12) The Effect of the Declaration- A large number of people believe it is a good idea for this document to address the problem of pregnancy. For this directive to come into effect after being diagnosed with an irreparable medical condition and/or being certified irreversibly brain-dead (even while pregnant), you must initial the first sentence of Article V, Section 1, which is the first phrase in Article V, Section 1.

(13) Refusal to Make a Pregnancy Declaration - If you want to declare this piece of paper null and invalid for the length of your pregnancy, begin the second sentence with an asterisk before the first phrase. If you get pregnant, all of the claims made on this page will be withdrawn immediately, regardless of your medical condition or estimated life duration in the future.

Further Instructions

(14) Instructions for direct health-care delivery- You have total discretion over whether or not to modify or delete any element of the preceding instruction. Article 6 provides an opportunity for you to communicate any additional medical advice or preferences with the Washington Medical Professionals who are examining this text. You may attach a document that is named and then recognized in order to make it simpler for you to discover the information you are looking for (e.g., "Attachment A"). Before making any modifications (removals or additions) to your prescription regimen, it is recommended that you contact with a Washington Medical Professional.

Signature of Washington's Declarant

(16) Please add your signature, as well as the date on which you signed the document. Signing and dating this document is required in order for it to be recognized as an official declaration of your medical preference in the state of Washington. In this state, you will need two Witnesses or a Notary Public to validate your signature and date, so make sure they are present when you sign your name and write the current calendar date in the appropriate field on the form.

Witnesses' Statements

(16) Preparation of a statement. In order to be valid, the "Statement of Witnesses" must have the signature of the Washington Declarant (You).

Signature of the First Witness

(17) Requirements for the Signatures of Witnesses- After signing your name in front of a first Witness who is an adult and is not under your control, you must evaluate what you stated in order to go on. At this stage, the Witness is needed to sign his or her name and make a notation on the document about the date it was signed. All signing dates will be the same, so keep that in mind while making your decision.

(18) Witness 1's Contact Information- Witness 1 must be available at some time in the near future in order for you to assert that he or she is competent to validate your signature. It is necessary to provide the location and phone number of witness 1 in order to do this.

(19) Witness Signature Requirements It is via the signature of Witness No. 2 that you will be able to demonstrate that you signed your name and that the statement on display is correct. Immediately after the signature of his or her name, witness 2 is required to state the date on which he or she signed this document.

(20) The complete Contact Information for the 2nd Witness - By giving Witness 2 his or her address and phone number, he or she will establish himself or herself as a reputable source of signature verification.


(21) The Action of the Public Notary-Notary Publics who are authorized by the State of Washington to witness the execution of your signature is allowed to do so. The Notary Public will record the facts of your signature as well as his or her qualifications when he or she is happy with the signing procedure. Many individuals believe that when two Witnesses or one Notary Public may witness the execution of a document, both should be done, rather than just one. As a consequence of this, your signature will be validated to be as legitimate as is reasonably feasible.

Download our free Washington living will in an instant to create a legally binding document.

Download our free Washington living will in an instant to create a legally binding document.

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