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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link="#0563C1" vlink="#954F72"><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D'>Eric: When there is no enforcement mechanism, such an obligation becomes an ethical issue. Will the doctor be influenced by financial considerations? I think some will. I tell my clients to discuss the directive (and POLST) with their doctors, so they have confidence the doctor is on board with the plan.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D'>Thomas Stuen<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>From:</span></b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> wsbapt-bounces@lists.wsbarppt.com [mailto:wsbapt-bounces@lists.wsbarppt.com] <b>On Behalf Of </b>Eric Reutter<br><b>Sent:</b> Wednesday, October 21, 2015 1:01 PM<br><b>To:</b> wsbapt@lists.wsbarppt.com<br><b>Subject:</b> [WSBAPT] Advance Directives - Obligations of health care providers<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><div><div><div><p class=MsoNormal style='margin-bottom:12.0pt'>Hello and good afternoon,<o:p></o:p></p></div><div><p class=MsoNormal>I am a UW Tax LLM student interested in Estate Planning. I have a question related to a basic article about Advance Directives that I am currently drafting. I have combed through the relevant RCW and WAC sections, but I believe that my question is one that requires practice experience to answer.<o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><p class=MsoNormal style='margin-bottom:12.0pt'>I have encountered what, in my opinion seems to be some gray-area in Washington law regarding health care provider's responsibilities under Advance Directives. While I understand that the Natural Death Act explicitly permits health care providers to decline to participate in withholding life-sustaining treatment, and that they are then required to inform the patient of any such conflicting policies (RCW 70.122.060), I am less clear regarding their responsibilities if they choose not to honor the applicable advance directive when their patient is both incapacitated and without a health care agent or guardian.<o:p></o:p></p><div><p class=MsoNormal style='margin-bottom:12.0pt'>I understand that WAC 182-501-0125 requires health care providers to "Make a good faith effort to transfer the client to another health care practitioner who will honor the directive<i> if the client chooses not to retain the facility or organization</i>." But I am trying to understand the obligations (if any) of the health care provider when the patient is permanently unconscious and does not have a health care agent or a guardian appointed.<br><br>My ultimate question is,<b><i> in this circumstance, would a health care provider still have an obligation to make a good-faith effort to transfer a patient to a health care practitioner who will honor the directive?</i></b><o:p></o:p></p></div><div><p class=MsoNormal style='margin-bottom:12.0pt'>My hunch is that, if a health care facility were in this situation and refusing to honor the directive, a patient's family or friend could petition for guardianship of the patient, and then have the power to move them to a different facility that would honor the advance directive. If the patient did not have such a guardian step in, however, I cannot envision how the health care facility would be under any legal obligation to transfer the patient, unless WAC 182-501-0125(6)(d) were to be interpreted quite broadly by a court. <o:p></o:p></p></div><p class=MsoNormal>I am curious if I am understanding the legal obligations (or lack thereof) of a health care provider in this situation. Any thoughts would be greatly appreciated. <o:p></o:p></p></div><p class=MsoNormal><o:p> </o:p></p><div><p style='margin:0in;margin-bottom:.0001pt'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>Eric Reutter</span><o:p></o:p></p><p style='margin:0in;margin-bottom:.0001pt'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>Tax LLM Candidate 2016</span><o:p></o:p></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>University of Washington School of Law</span><o:p></o:p></p></div></div></div></body></html>