FAQs About Advance Directives

The decision to have written directives is a very personal one. The best way to make your wishes known is to put them in writing. Some people find it comforting to have written directives because they feel it eases the decision-making burden for family and friends.

Washington state law sets the following order of priority for people to make decisions on your behalf if you are not able to make decisions for yourself:

  1. Your guardian, if one has been appointed
  2. The person named in your Durable Power of Attorney for Health Care
  3. Your spouse/registered partner
  4. Your adult children
  5. Your parents
  6. Your adult brothers and/or sisters

The person chosen to make decisions on your behalf is responsible by state law to follow your wishes as stated in your directives.

Yes, you may change or cancel a Health-Care Directive or Durable Power of Attorney for Health Care at any time. Simply destroy the document, put your change in writing, or tell your physician, nurse and family about the change. If you change your directive, you should give new copies to your family, physician, lawyer or others who may be involved. Your physician must know about the change or it will not be effective.

Your physician and the hospital will honor Advance Directives that meet the requirements of Washington state law and standards of medical ethics. If a hospital or physician cannot honor an Advance Directive, they are required by law to make an effort to transfer you to a physician or hospital that will.

There are several life-sustaining treatments and medical interventions that can lengthen a person’s life, delaying the moment of death. We would like you to consider these and discuss your choices with your family, friends and physician. It is important your wishes be known in case you're unable to speak for yourself. Life-sustaining treatments do not include procedures or medicine given to relieve pain. A decision to forego life-sustaining treatment will in no way affect the care you are given to provide comfort and reduce pain. Supportive care given for comfort and pain relief will always be provided.

The following are life-sustaining treatments:

  • Cardiopulmonary Resuscitation (CPR): CPR is used when a person’s heart or lungs have suddenly stopped working. It usually involves chest compressions, the use of drugs and/or electric shock to restore the heartbeat, and the placement of a tube in the windpipe to maintain breathing. CPR may not be appropriate for certain patients, (such as those in the process of dying due to terminal illness, those in a persistent vegetative state or those with an incurable illness), as its use would only lengthen the process of dying. Swedish CPR Policy.
  • Respirator/Ventilator: A respirator/ventilator is a machine that, by moving air into the lungs, breathes for a person who is unable to breathe naturally. Ventilators are sometimes used after a person has had surgery or when a person has an illness. The ventilator helps the person breathe until he or she is able to do so on his or her own. A ventilator may not be appropriate for a patient with a terminal illness, however, because it may only prolong the process of dying.
  • Artificial Nutrition and Hydration: Artificial nutrition and hydration are ways to provide food or fluids to a person who is unable to eat or drink. Food and/or fluids can be given directly or indirectly into the stomach (also called “tube feeding”) or through an intravenous line. These methods are commonly used when there is a temporary loss of eating or digestive function. When death is certain or there is no hope for recovery, the use of artificial food and fluids may only prolong the process of dying.

Swedish respects the rights and responsibilities of patients to make choices about their health care, including decisions regarding withholding or withdrawing life-sustaining treatment. We are committed to providing you with health-care treatment information and listening to your treatment choices. You have the right to accept or refuse any medical treatment. We will not discriminate against anyone based on whether or not the person has written an Advance Directive.

We will honor treatment decisions stated in your Advance Directives, except where we believe it is not medically indicated or unethical to do so. If the medical center or physician cannot honor your Advance Directive based on the above policies, we will make every effort to transfer you to a facility that will.

When you're admitted as a patient or come for a pre-admission visit prior to surgery, you'll be asked if you have completed a Health-Care Directive, Durable Power of Attorney for Health Care, or if you want to be an organ donor.

If you're admitted to a hospital, bring copies of your written directives. They will be placed in your medical record.

For questions or more information about Advance Directives, please consult your physician or contact the Swedish Pre-Admission Center at 206-386-2997.