Washington Law Review


In a hospital in the State of Washington, at the direction of family-member surrogates, the feeding tube was withdrawn from a resident patient. The patient had no advance directive or living will, nor had he expressed the desire (previously or contemporaneously) for withdrawal of life support. He had not been diagnosed as terminally ill or permanently unconscious. In fact, there was evidence that the patient had some cognitive function, desired to continue living, and desired continued life support. This evidence was presented to his caregivers immediately after the patient was advised of the withdrawal, yet life support was not resumed until five days later, and only after a court so ordered. What happened to this patient raises fundamental questions about the procedures to be followed before life support is withdrawn from a patient who has not made an advance directive, the safeguards for ascertaining a patient's condition and wishes, and the situations in which a surrogate may direct life-support removal. May hospitals and doctors terminate life support at the direction of a surrogate without assurance that the patient (a) is terminally ill or permanently unconscious, and (b) cannot make and express his or her own decision whether to live or die? Are procedural safeguards defined solely by hospitals' and doctors' standards of care, or must they include standards articulated by the state's highest court?

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