Wash. Rev. Code § 7.70.065

Informed consent — Persons authorized to provide for patients who are not competent — Priority

Washington has established the following prioritized list of persons that may provide informed consent in the event that a person is not competent to provide consent for any reason other than the fact that they are under the age of 18:

•         The patient’s guardian
•         An individual authorized by a power of attorney
•         Spouse or domestic partner
•         Children over the age of 18
•         Parents
•         Adult siblings

Health care providers must “make reasonable efforts” to obtain informed consent from persons with first priority on the list before proceeding down the list. Persons may not give informed consent if a person with higher priority refuses to consent or there are multiple persons with authority in their class and consent is not unanimous.

Persons authorized to give informed consent must make a good faith determination that the person on whose behalf they are consenting would have provided consent. If they cannot make such determination, then they may still provide consent if the treatment is in the patient’s best interests.

The following persons, listed in order of priority, may provide informed consent for a person who is not competent to provide consent because they are under the age of 18:

•         The patient’s guardian or legal custodian.
•         If the patient is in a group or foster home, a person authorized by a court may consent for their medical care.
•         The patient’s parents.
•         A person whom the patient’s parents have authorized, in writing, to make medical decisions.
•         A “competent adult” relative that declares, in writing and “under penalty of perjury,” that they are responsible for the patient’s health care. Providers do not have to rely on such representation and hospitals may require the “competent adult” to provide documentation regarding their relationship with the patient. Providers and facilities that treat a patient in reliance on a “competent adult’s” written statement are immune from liability.