Medical Power of Attorney in Washington State: How to Appoint a Health Care Agent

When you can't speak for yourself in a hospital, someone else will. The question is whether that person is someone you chose — or someone a statute picked for you.

Washington's Durable Power of Attorney for Health Care (DPOA-HC), governed by Chapter 11.125 RCW, lets you designate a specific person to make medical decisions on your behalf when you lack capacity. Without one, decisions fall to Washington's default surrogate hierarchy under RCW 7.70.065, which ranks family members in a rigid order and requires unanimous agreement within each class.

What Authority Does a Health Care Agent Have?

A properly appointed agent can:

• Consent to or refuse medical treatments, including surgery, medication, and life-sustaining measures
• Access your medical records and consult with physicians
• Choose care facilities — hospitals, nursing homes, hospice programs
• Make decisions about diagnostic procedures and rehabilitation
• Handle organ donation and autopsy decisions after death (authority extends post-death under RCW 68.50.160)

One hard limit: a healthcare agent cannot request or consent to medical aid in dying under Washington's Death with Dignity Act. That decision must remain strictly personal, voluntary, and self-administered.

Who Can Serve as Your Agent

Any competent adult can serve as your healthcare agent, with a few statutory restrictions. Under RCW 11.125, the following people cannot act as your agent:

• Your attending physician (unless they're a relative)
• An employee of your attending physician (unless related)
• An owner, administrator, or employee of the healthcare facility where you receive treatment (unless related by blood or marriage)

Beyond the legal restrictions, practical considerations matter more. Choose someone who:

• Lives close enough to reach a hospital quickly (or can travel on short notice)
• Can handle high-pressure decisions without freezing
• Will follow your documented wishes even when family members push back
• Understands your values around quality of life, pain management, and treatment intensity

Name a successor agent in case your primary choice is unavailable, unwilling, or has become incapacitated themselves.

Signing Requirements Under RCW 11.125.050

The DPOA-HC must be signed and dated by you (the principal). Then you need one of:

Notary acknowledgment — the simplest and cleanest option. A notary witnesses your signature. No additional witnesses needed.

Two qualified witnesses — both must be present when you sign. Witnesses cannot be:

• Related to you by blood, marriage, or domestic partnership
• Named as your healthcare agent
• A paid home care provider for you
• A care provider at your adult family home or long-term care facility

These disqualification rules are slightly different from the ones that apply to a living will (Health Care Directive under RCW 70.122). If you're executing both documents at the same time, use the notary route for both to avoid any eligibility confusion.

When the DPOA-HC Activates

You have two options for activation:

Immediate effect — the agent's authority begins the moment you sign. This doesn't mean they can override your decisions while you're competent; you retain full decision-making authority as long as you have capacity. But it avoids delays if you suddenly lose capacity.

Springing power — the agent's authority activates only when a physician documents that you lack decision-making capacity. This requires a medical determination, which can take time in an emergency.

Most estate planning attorneys in Washington recommend the immediate-effect version. A springing power can create dangerous gaps if a physician hasn't formally documented incapacity and an urgent decision needs to be made.

What Happens Without a DPOA-HC

Without a designated agent, Washington's surrogate hierarchy under RCW 7.70.065 determines who makes your medical decisions. The order is:

1. Court-appointed guardian
2. Designated agent (DPOA-HC)
3. Spouse or registered domestic partner
4. Adult children (must agree unanimously)
5. Parents
6. Adult siblings (must agree unanimously)
7. Adult grandchildren (unanimous)
8. Adult nieces and nephews (unanimous)
9. Adult aunts and uncles (unanimous)
10. A qualified "close friend"

The unanimity requirement is where this system breaks down. If you have four adult children and one disagrees about a treatment plan, the hospital cannot proceed. The family may need to petition the court — a process that takes weeks while you're lying in a bed without a decision.

Being a community property state doesn't help here. Community property governs asset ownership, not medical authority. Your spouse still shares decision-making priority with any objecting family members under the statute.

Keeping Your DPOA-HC Current

After divorce: Washington law (RCW 11.125.085) automatically revokes a former spouse's authority as your healthcare agent when divorce is finalized. You need to execute a new DPOA-HC naming someone else.

After your agent's death or incapacity: If your primary agent can no longer serve and you didn't name a successor, you're back to the default hierarchy. Update immediately.

Storage: Give copies to your agent, your primary care physician, your local hospital, and at least one other trusted person. Washington's Health Care Declarations Registry has been suspended, so there's no state-level digital repository.

Washington's advance directive kit pairs the DPOA-HC with the Health Care Directive, body disposition instructions, and a witness eligibility checklist — so both documents work together instead of contradicting each other.

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