<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:m="http://schemas.microsoft.com/office/2004/12/omml" xmlns="http://www.w3.org/TR/REC-html40"><head><meta http-equiv=Content-Type content="text/html; charset=utf-8"><meta name=Generator content="Microsoft Word 15 (filtered medium)"><!--[if !mso]><style>v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style><![endif]--><style><!--
/* Font Definitions */
@font-face
{font-family:Helvetica;
panose-1:2 11 6 4 2 2 2 2 2 4;}
@font-face
{font-family:"Cambria Math";
panose-1:2 4 5 3 5 4 6 3 2 4;}
@font-face
{font-family:Calibri;
panose-1:2 15 5 2 2 2 4 3 2 4;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0in;
font-size:11.0pt;
font-family:"Calibri",sans-serif;}
a:link, span.MsoHyperlink
{mso-style-priority:99;
color:blue;
text-decoration:underline;}
span.apple-converted-space
{mso-style-name:apple-converted-space;}
.MsoChpDefault
{mso-style-type:export-only;
font-size:10.0pt;}
@page WordSection1
{size:8.5in 11.0in;
margin:1.0in 1.0in 1.0in 1.0in;}
div.WordSection1
{page:WordSection1;}
--></style><!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1026" />
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1" />
</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:14.0pt;font-family:"Arial",sans-serif'>I have always explained it to my clients like this:<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt;font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt;font-family:"Arial",sans-serif'>We all need food and water to survive, even if we are perfectly healthy. If we stopped eating and drinking, we would die. Because that is the case, some people believe that artificial nutrition and hydration are not “life support” in the same way that a ventilator and other machines would be. There is a separate paragraph in the Health Care Directive about artificial nutrition and hydration so that everyone can make a separate decision about what they want and do not want.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt;font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt;font-family:"Arial",sans-serif'>The majority of my clients want neither—if the HCD applies, they do not want artificial nutrition or hydration to prolong their dying. A significant minority choose to have artificial hydration but not nutrition, because they believe it would be uncomfortable to die of thirst. Very few people want both artificial nutrition and hydration, but a few do.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt;font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt;font-family:"Arial",sans-serif'>Sandra Perkins<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt;font-family:"Arial",sans-serif'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b>From:</b> <a href="mailto:wsbapt-bounces@lists.wsbarppt.com">wsbapt-bounces@lists.wsbarppt.com</a> <<a href="mailto:wsbapt-bounces@lists.wsbarppt.com">wsbapt-bounces@lists.wsbarppt.com</a>> <b>On Behalf Of </b>Jane Bitz<br><b>Sent:</b> Tuesday, August 25, 2020 6:40 PM<br><b>To:</b> WSBA Probate & Trust Listserv <<a href="mailto:wsbapt@lists.wsbarppt.com">wsbapt@lists.wsbarppt.com</a>><br><b>Subject:</b> Re: [WSBAPT] Conflict in Health Care Directive<o:p></o:p></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='font-size:14.0pt'>I think the specific language indicating the patient’s wishes should always be read to modify the general language in the introduction to the directive. <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt'>Interesting that if a client indicates that they want life support, even with a terminal or permanent unconscious condition, then we should probably not use the language from the statute. Or say in the introduction “I understand that I have a right to accept or refuse treatment that would simply prolong the process of my dying as indicated below.”<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:14.0pt'><o:p> </o:p></span></p><div><p class=MsoNormal>Jane G. Bitz<o:p></o:p></p><p class=MsoNormal>Of Counsel<o:p></o:p></p><p class=MsoNormal>Wolff, Hislop & Crockett, PLLC<o:p></o:p></p><p class=MsoNormal>12209 E. Mission Ave, Suite 5<o:p></o:p></p><p class=MsoNormal>Spokane Valley, WA 99206-4824<o:p></o:p></p><p class=MsoNormal>(509) 927-9700 x126<o:p></o:p></p><p class=MsoNormal>FAX: (509) 777-1800<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:#1F497D'><img border=0 width=191 height=96 style='width:1.9916in;height:1.0in' id="Picture_x0020_1" src="cid:image001.jpg@01D67B13.99EBC990" alt="image001 (4)"></span><span style='color:black'><img border=0 width=115 height=100 style='width:1.2in;height:1.0416in' id="Picture_x0020_2" src="cid:image002.png@01D67B13.99EBC990"><img border=0 width=273 height=96 style='width:2.8416in;height:1.0in' id="Picture_x0020_3" src="cid:image003.jpg@01D67B13.99EBC990"></span><o:p></o:p></p><p class=MsoNormal><b><i><span style='font-size:12.0pt;color:#2F5496'>THE CONTENTS OF THIS ELECTRONIC MAIL ARE CONFIDENTIAL AND PROTECTED BY THE ATTORNEY-CLIENT PRIVILEGE OR OTHER APPLICABLE PROTECTION.</span></i></b><i><span style='font-size:12.0pt;color:#2F5496'> Any review, use, distribution or disclosure by others is strictly prohibited. <u>If you have received this electronic mail in error</u>, <b>PLEASE NOTIFY ME BY E-MAIL, FAX OR TELEPHONE and PROMPTLY DELETE</b> this electronic mail. This mail cannot be modified without express written consent of Wolff, Hislop & Crockett, PLLC. Thank You.<o:p></o:p></span></i></p></div><p class=MsoNormal><span style='font-size:14.0pt'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b>From:</b> <a href="mailto:wsbapt-bounces@lists.wsbarppt.com">wsbapt-bounces@lists.wsbarppt.com</a> <<a href="mailto:wsbapt-bounces@lists.wsbarppt.com">wsbapt-bounces@lists.wsbarppt.com</a>> <b>On Behalf Of </b>Krista MacLaren<br><b>Sent:</b> Tuesday, August 25, 2020 5:01 PM<br><b>To:</b> wsba probate & trust <<a href="mailto:wsbapt@lists.wsbarppt.com">wsbapt@lists.wsbarppt.com</a>>; Marcus Fry <<a href="mailto:mfry@LYON-LAW.COM">mfry@LYON-LAW.COM</a>><br><b>Subject:</b> Re: [WSBAPT] Conflict in Health Care Directive<o:p></o:p></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>I always took the life-sustaining treatment language to relate to ventilators, anti-biotic drips, or things other than nutrition/hydration. I will be interested to see what others say. <o:p></o:p></p><div><p class=MsoNormal><o:p> </o:p></p><div><div><p class=MsoNormal style='margin-bottom:12.0pt'><span style='font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black'>Krista J. MacLaren<br>Attorney at Law<br>Northgate Executive Center II<br>9725 3rd Ave NE, Suite 600<br>Seattle WA 98115<br>(206) 523-6116<br><a href="mailto:kjm.inc@icloud.com">kjm.inc@icloud.com</a><br><br>Please note, as with most email providers, Mac does not encrypt email messages. Accordingly, the confidentiality of messages sent to this address cannot be assured. This e-mail is intended for viewing only by the individual or entity to whom its content is addressed, and it may contain confidential or privileged information. If you received this email in error, please honor the privacy of the intended recipient: reply to the sender regarding the error and delete the message.<o:p></o:p></span></p></div></div><div><p class=MsoNormal style='margin-bottom:12.0pt'><o:p> </o:p></p><blockquote style='margin-top:5.0pt;margin-bottom:5.0pt'><div><p class=MsoNormal>On Aug 25, 2020, at 4:49 PM, Marcus Fry <<a href="mailto:mfry@lyon-law.com">mfry@lyon-law.com</a>> wrote:<o:p></o:p></p></div><p class=MsoNormal><o:p> </o:p></p><div><div><p class=MsoNormal style='background:white'><a name="_GoBack"></a><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>I have not run into this and therefore interested in thoughts on the same. Below is the statute for our state’s health care directive. I have a developing medical situation that the woman is in a coma has a health care directive (appears to be a pre-printed form) that has the exact language from RCW 70.122.030 directing “treatment be withheld or withdrawn”, but chose the option of “I DO” want artificially provided nutrition and hydration. How does one reconcile these two statements? </span><o:p></o:p></p></div><div><p class=MsoNormal style='background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'> </span><o:p></o:p></p></div><div><p class=MsoNormal style='background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'> </span><o:p></o:p></p></div><div><p class=MsoNormal style='background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>RCW 70.122.030(1):</span><o:p></o:p></p></div><div><p class=MsoNormal style='background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'> </span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>Directive made this . . . . day of . . . . . . (month, year).</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>I . . . . . ., having the capacity to make health care decisions, willfully, and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, and do hereby declare that:</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>(a)<span class=apple-converted-space> </span><span style='background:yellow'>If at any time I should be diagnosed in writing to be in</span><span class=apple-converted-space> </span>a terminal condition by the attending physician, or in<span class=apple-converted-space> </span><span style='background:yellow'>a permanent unconscious condition by two physicians, and where the application of life-sustaining treatment would serve only to artificially prolong the process of my dying, I direct that such treatment be withheld or withdrawn, and that I be permitted to die naturally.</span><span class=apple-converted-space> </span>I understand by using this form that a terminal condition means an incurable and irreversible condition caused by injury, disease, or illness, that would within reasonable medical judgment cause death within a reasonable period of time in accordance with accepted medical standards, and where the application of life-sustaining treatment would serve only to prolong the process of dying. I further understand in using this form that a permanent unconscious condition means an incurable and irreversible condition in which I am medically assessed within reasonable medical judgment as having no reasonable probability of recovery from an irreversible coma or a persistent vegetative state.</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>(b) In the absence of my ability to give directions regarding the use of such life-sustaining treatment, it is my intention that this directive shall be honored by my family and physician(s) as the final expression of my legal right to refuse medical or surgical treatment and I accept the consequences of such refusal. If another person is appointed to make these decisions for me, whether through a durable power of attorney or otherwise, I request that the person be guided by this directive and any other clear expressions of my desires.</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>(c)<span class=apple-converted-space> </span><span style='background:yellow'>If I am diagnosed to be in a</span><span class=apple-converted-space> </span>terminal condition or in a<span class=apple-converted-space> </span><span style='background:yellow'>permanent unconscious condition</span><span class=apple-converted-space> </span>(check one):</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black;background:yellow'>I DO want to have artificially provided nutrition and hydration.</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>I DO NOT want to have artificially provided nutrition and hydration.</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>(d) If I have been diagnosed as pregnant and that diagnosis is known to my physician, this directive shall have no force or effect during the course of my pregnancy.</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>(e) I understand the full import of this directive and I am emotionally and mentally capable to make the health care decisions contained in this directive.</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>(f) I understand that before I sign this directive, I can add to or delete from or otherwise change the wording of this directive and that I may add to or delete from this directive at any time and that any changes shall be consistent with Washington state law or federal constitutional law to be legally valid.</span><o:p></o:p></p></div><div><p class=MsoNormal style='text-indent:.5in;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>(g) It is my wish that every part of this directive be fully implemented. If for any reason any part is held invalid it is my wish that the remainder of my directive be implemented.</span><o:p></o:p></p></div><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=324 style='width:243.0pt;border-collapse:collapse'><tr><td valign=top style='padding:.75pt .75pt .75pt .75pt'><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Times New Roman",serif'> </span><o:p></o:p></p></div></td><td valign=top style='padding:.75pt .75pt .75pt .75pt'><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Times New Roman",serif'>Signed . . . .</span><o:p></o:p></p></div></td></tr></table><p class=MsoNormal align=center style='text-align:center;background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>City, County, and State of Residence</span><o:p></o:p></p><div><p class=MsoNormal style='background:white'><span style='font-size:12.0pt;font-family:"Helvetica",sans-serif;color:black'>The declarer has been personally known to me or has provided proof of identity and I believe him or her to be capable of making health care decisions.</span><o:p></o:p></p></div><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=324 style='width:243.0pt;border-collapse:collapse'><tr><td valign=top style='padding:.75pt .75pt .75pt .75pt'><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Times New Roman",serif'> </span><o:p></o:p></p></div></td><td valign=top style='padding:.75pt .75pt .75pt .75pt'><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Times New Roman",serif'>Witness . . . .</span><o:p></o:p></p></div></td></tr><tr><td valign=top style='padding:.75pt .75pt .75pt .75pt'><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Times New Roman",serif'> </span><o:p></o:p></p></div></td><td valign=top style='padding:.75pt .75pt .75pt .75pt'><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Times New Roman",serif'>Witness . . . .</span><o:p></o:p></p></div></td></tr></table><div><p class=MsoNormal> <o:p></o:p></p></div><div><p class=MsoNormal> <o:p></o:p></p></div><p class=MsoNormal style='text-align:justify'><span style='font-size:10.0pt;font-family:"Arial",sans-serif'>Thank you,</span><o:p></o:p></p><p class=MsoNormal style='text-align:justify'><span style='font-size:10.0pt;font-family:"Arial",sans-serif'> </span><o:p></o:p></p><p class=MsoNormal style='text-align:justify'><span style='font-size:10.0pt;font-family:"Arial",sans-serif'>Marcus J. Fry</span><o:p></o:p></p><div><p class=MsoNormal style='margin-bottom:12.0pt'><span style='font-size:10.0pt;font-family:"Arial",sans-serif'>Lyon, Weigand & Gustafson, P.S.<span class=apple-converted-space> </span></span><o:p></o:p></p></div><p class=MsoNormal style='text-align:justify'><b><span style='font-size:10.0pt;font-family:"Arial",sans-serif'>Confidentiality:<span class=apple-converted-space> </span></span></b><span style='font-size:10.0pt;font-family:"Arial",sans-serif'>This e-mail transmission may contain information which is protected by attorney-client, work product and/or other privileges. If you are not the intended recipient, you are hereby notified that any disclosure, or taking of any action in reliance on the contents, is strictly prohibited. If you have received this transmission in error, please contact us immediately and return the e-mail to us by choosing Reply (or the corresponding function on your e-mail system) and then deleting the e-mail.</span><o:p></o:p></p><div><p class=MsoNormal> <o:p></o:p></p></div><p class=MsoNormal><span style='font-size:9.0pt;font-family:"Helvetica",sans-serif'>***Disclaimer: Please note that RPPT listserv participation is not restricted to practicing attorneys and may include non-practicing attorneys, law students, professionals working in related fields, and others.***<br>_______________________________________________<br>WSBAPT mailing list<br></span><a href="mailto:WSBAPT@lists.wsbarppt.com"><span style='font-size:9.0pt;font-family:"Helvetica",sans-serif;color:purple'>WSBAPT@lists.wsbarppt.com</span></a><span style='font-size:9.0pt;font-family:"Helvetica",sans-serif'><br></span><a href="http://mailman.fsr.com/mailman/listinfo/wsbapt"><span style='font-size:9.0pt;font-family:"Helvetica",sans-serif;color:purple'>http://mailman.fsr.com/mailman/listinfo/wsbapt</span></a><o:p></o:p></p></div></blockquote></div><p class=MsoNormal><o:p> </o:p></p></div></div></body></html>