A Health Care Directive (HCD) — sometimes called a Living Will or an Advance Directive — allows a client to provide written instructions regarding life-sustaining treatment. Within the Agile EP forms, the Health Care Directive works together with the Health Care Power of Attorney to cover end-of-life decision-making.
The documents divide responsibility as follows:
The Health Care Directive provides specific instructions regarding life-sustaining treatment, comfort care, and organ donation.
The Health Care Power of Attorney appoints the decision-maker and governs all other medical decisions.
This article explains how to complete the Health Care Directive within Agile EP. For guidance on appointing a health care agent, see: How do I draft a Health Care Power of Attorney?
Completing the Health Care Directive Section
The Directive selections appear in the lower portion of the Health Care Choices tab. Each selection determines the language included in the final Directive document.
Organ Donation
You must determine whether the client wishes to authorize organ and tissue donation.
- If donation is authorized, the Directive will include language permitting organ and tissue recovery consistent with Washington law.
- If donation is declined, the Directive will state that no anatomical gift is authorized.
- If the client prefers flexibility, the Directive may leave the decision to the appointed health care agent.
Life-Sustaining Treatment
You must determine whether the client wishes to receive or decline life-sustaining treatment in a qualifying end-of-life condition.
- If the client elects to decline life-sustaining treatment, the Directive will instruct providers to withhold or withdraw artificial life-prolonging procedures when the statutory conditions are met.
- If the client elects to receive life-sustaining treatment, the Directive will direct providers to continue such measures.
This language governs decisions involving artificial life support when the client is terminally ill or permanently unconscious.
Regardless of the client's decision to give or remove life-sustaining treatment, the Directive will include a requiest to provide comfort measures to be kept pain free.
Binding or Advisory Effect
You must determine whether the Directive is binding on the Health Care Agent, or is guidance only.
- If binding, the Directive requires the agent and medical providers to follow the client’s expressed wishes regarding life-sustaining treatment.
- If guidance only, the Directive instructs the agent to consider the client’s preferences but permits discretion based on the circumstances.
This selection determines how strictly the agent must adhere to the written instructions.
Execution of the Health Care Directive
The Directive has its own execution block, separate from the HCPOA. Under Chapter 70.122 RCW, the Directive must be signed either:
Before a notary public, or
In the presence of qualified witnesses
The selection in the interview determines the signature block included in the final document. Be mindful of statutory restrictions on who may serve as a witness, although the requirements are stated in the document and in the document execution instructions.
Coordination with the Health Care Power of Attorney
The Health Care Directive does not appoint an agent. It provides instructions that are relevant in limited situations. The Health Care Power of Attorney appoints the decision-maker and offers guidance, preferences and a broad grant of authority.
When both documents are drafted:
The Directive governs life-sustaining treatment in terminal or persistent vegetative conditions.
The HCPOA governs all other medical decisions.
The health care agent must follow or consider the Directive depending on whether it is binding or advisory.
Together, the documents provide both authority and instruction across the full spectrum of medical decision-making.