Return to Laws and Medical Ethics.

Law and Medical Ethics:
footnotes

1. For example, the law provides for "implied consent" for emergency treatment situations. Washington law states: If a recognized health care emergency exists and the patient is not legally competent to give an informed consent and/or a person legally authorized to consent on behalf of the patient is not readily available, his consent to required treatment will be implied. RCW 7.70.050(4).

However, the hospital policy may be more specific and include an institutional documentation standard. For example, Harborview and University of Washington Medical Centers' Consent Manual defines what the University's teaching hospitals will consider an "emergency" (i.e., treatment required to preserve life or to prevent serious impairment of bodily functions) and sets an institutional documentation standard for content (i.e., chart in the medical record the nature of the threat to life or health, its immediacy, and its magnitude).

Return

2. George Annas, Standard of Care: The Law of American Bioethics, New York, Oxford University Press (1993).

Return

3. The author wishes to thank Dr. Tom McCormick for permission to modify and use these case studies.

Use the Back button to return to the case.

4. Washington law allows designated classes of persons to provide informed consent on behalf of an incompetent patient in the following order of priority: 1. guardian with authority make health care decisions; 2. holder of Durable Power of Attorney with authority to make health care decisions; 3. spouse; 4. adult children; 5. parents; and 6. adult brothers and sisters. See RCW 7.70.065. If there are two or more persons in the same class listed above (ex., adult children), then the decision must be unanimous among all available persons in that class.

Return

5. Washington's Natural Death Act (RCW 70.122) defines the terms "terminal condition," "permanent unconscious condition" and "life-sustaining treatment," but this living will predated the 1992 amendments.

Return