Medical power of attorney in Washington: how it works, how to sign
The short answer
In Washington, medical decisions go in a durable power of attorney for health care, which must expressly grant that authority. You sign it before a notary or two qualified witnesses. If you name nobody, the law turns to a guardian, then your spouse, adult children, parents, siblings, other relatives, and last a close friend.
The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?
Washington answers it a little differently from many states. There is no separate health care proxy law. Instead, you give someone medical authority in a durable power of attorney, often called a "durable power of attorney for health care." This page covers how to sign one, who can't witness it, how the living will fits in, and who decides if you name nobody. It is part of our guides to estate planning by state. For the basics of the role, see what a medical power of attorney is.
What makes it a health care power of attorney?
The document must expressly grant authority to make health care decisions (RCW 11.125.240). A general grant of financial powers doesn't include medical decisions.
Some people put both kinds of authority in one document. Many prefer two separate documents, so the bank never sees their medical wishes and the hospital never sees their accounts. Either way, the health care grant has to be spelled out.
A general health care grant also makes your agent your "personal representative" under the federal privacy law, HIPAA (RCW 11.125.400). That means doctors can share your records with them.
Washington has no official statutory form for this document. Any writing that meets the rules works.
How do I sign one in Washington?
You sign and date it. Then you either acknowledge it before a notary, or have two or more competent witnesses sign it in your presence (RCW 11.125.050).
These people can't be your witnesses:
- Your home care provider.
- A care provider at an adult family home or long-term care facility where you live.
- Anyone related to you or to your agent by blood, marriage or state registered domestic partnership.
A notary avoids those questions. Our Washington financial power of attorney guide covers the money side, which uses the same signing rules.
Who can't be my agent?
Washington rules out a few people as your health care agent (RCW 11.125.400):
- Your physicians and their employees.
- Owners, administrators and employees of the facility where you live or get care.
There is one exception. Any of those people can serve if they are your spouse, domestic partner, parent, adult child or brother or sister.
Your agent is a fiduciary: legally required to act in your interest and follow what you wrote. In daily terms, that means talking with your doctors, reading your chart, and saying yes or no to a test or a new medicine in light of your wishes.
Do I need a living will too?
Many people sign both. A health care power of attorney names a person. A living will writes down your wishes about treatment, so that person isn't guessing.
Washington calls its living will a "health care directive" (RCW 70.122.030). It says whether you want life-sustaining treatment withheld or withdrawn if you have a terminal condition or are permanently unconscious. The statute includes an optional form, with a choice about artificially provided food and fluids.
It is signed with a notary or two witnesses, but the witness list is different from the power of attorney's. A directive witness can't be:
- Related to you by blood or marriage.
- Someone who would inherit from you, under a will or by law.
- Your attending physician, or an employee of that physician or of a health facility where you are a patient.
- Someone your estate would owe money to.
A directive made in another state is valid to the extent Washington law allows. Our post on health care power of attorney vs living will explains how the two work together, and treatment preferences helps you think through what to write.
Who decides if I haven't named anyone?
Washington law sets a list. If you can't make decisions, informed consent can come from the first available group, in this order (RCW 7.70.065):
| Order | Who can decide |
|---|---|
| 1 | Your court-appointed guardian |
| 2 | Your agent under a durable power of attorney that covers health care |
| 3 | Your spouse or state registered domestic partner |
| 4 | Your adult children |
| 5 | Your parents |
| 6 | Your adult brothers and sisters |
| 7 | Adult grandchildren who are familiar with you |
| 8 | Adult nieces and nephews who are familiar with you |
| 9 | Adult aunts and uncles who are familiar with you |
| 10 | A close friend |
Two rules make the list harder to use than it looks. Nobody can consent if someone higher on the list has refused. And if two or more available people in the same group don't all agree, none of them can consent.
A close friend comes last and has to clear several hurdles. They must be an adult who has shown special care and concern, knows your values and is reasonably available. They can't be your doctor or the doctor's employee, someone who works at or runs a facility where you live or get care, or someone paid to care for you.
The friend must also sign a declaration under penalty of perjury. It says they are a close friend, have kept regular contact, and know of no higher-ranked person willing and able to decide. It lasts up to six months, and the provider may rely on it but doesn't have to.
Whoever decides must choose as you would have, or in your best interests if your wishes can't be known. You can see your own default order with our who decides for me tool, and the 50-state guide to default decision-makers shows how other states compare.
If the person who really knows your wishes is a friend or a niece, naming them in a health care power of attorney moves them to the front.
Here is a typical case, a composite. Patricia is 73, widowed, and lives in Bellingham. Her two sons live in different states and rarely agree. Her neighbor Ellen drives her to appointments and knows what she would want. Patricia names Ellen as her health care agent and her older son as backup.
How do I choose my agent?
Once the signing rules are clear, the practical questions matter most. Is the person willing? Can they get to the hospital? Will they follow your wishes even when they'd choose differently?
A short checklist:
- They know what you want, because you've told them.
- They can stay calm in a hospital hallway and ask questions.
- They live close enough, or can travel when needed.
- You've named a backup in case they can't.
Our post on how to choose a medical power of attorney has more questions to ask.
Some people would like a professional standing by, first or behind a friend. A Kinly membership includes a medical power of attorney written for your state, and Trella Trust Company, a Washington State chartered trust company, can be named in the role, first or as the backup to someone you choose.
When your health papers are done, our Washington probate guide covers what happens to your home and savings later.
Common questions
Does a medical power of attorney need to be notarized in Washington?
No. It must be notarized or signed by two qualified witnesses. Witnesses can't be related to you or your agent, or be your home care or facility care provider.
Is there an official Washington medical power of attorney form?
No. Washington has no statutory form for the health care power of attorney. The living will, called a health care directive, does have an optional form in the statute.
Who makes medical decisions in Washington if there's no power of attorney?
A guardian comes first. Then your spouse or registered domestic partner, adult children, parents, adult siblings, and then adult grandchildren, nieces and nephews, aunts and uncles who know you. A close friend is last.
Can a close friend make medical decisions for me in Washington?
Only as the tenth and last choice, and only after signing a declaration under penalty of perjury. Naming the friend as your health care agent avoids all of that.
Can my doctor be my health care agent?
Not unless your doctor is also your spouse, domestic partner, parent, adult child or sibling. The same limit applies to staff at the facility where you live or get care.
Sources
- RCW 11.125.240: Authority requiring specific grant (Washington Legislature)
- RCW 11.125.050: Execution requirements (Washington Legislature)
- RCW 11.125.400: Health care decisions (Washington Legislature)
- RCW 70.122.030: Health care directive (Washington Legislature)
- RCW 7.70.065: Informed consent for persons not competent (Washington Legislature)
This page is general information, not legal or financial advice. Laws vary by state.