In a recent blog post, Stacey discussed Washington’s newly enacted House Bill #1215, which removes the pregnancy exclusion from Washington State’s Natural Death Act. Under this new law, Washington residents who are pregnant can now decide whether they wish to receive life-sustaining treatment until the birth of their child or miscarriage. This change ensures that a pregnant individual’s health care directive will be honored, regardless of pregnancy status.
Washington is one of only a few states to make this statutory change. In over thirty states, pregnancy exclusions remain in effect, meaning that a woman’s expressed medical wishes in her health care directive may be suspended if she is pregnant.
The Washington Post recently reported on a lawsuit filed in Michigan that highlights this issue. Emergency medicine physician Dr. Viktoria Koskenoja and seven other Michigan residents, in coordination with Perkins Coie, LLP and other supporting firms, challenged Michigan’s advance directive law. Under Michigan’s statute, if a patient is pregnant her advance directive is automatically suspended, meaning her designated health care agent cannot withhold or withdraw life-sustaining treatment until the pregnancy ends. The plaintiffs argue that this restriction violates Michigan’s constitutional guarantee of reproductive freedom and denies pregnant individuals the same medical autonomy other adults have when making end-of-life decisions. This contrasts with Washington’s recent reform, which removed a similar pregnancy exclusion from the state’s Natural Death Act. Washington’s change applies specifically to a person’s health care directive, allowing pregnant individuals to decide in advance whether they would want life-sustaining treatment continued or withheld during pregnancy – ultimately restoring control to the patient rather than the state.
The debate in Michigan comes amid ongoing national decisions about reproductive rights following the Supreme Court’s decision to overturn Roe v. Wade. Similar to Washington’s recent reform, Michigan lawmakers are considering whether to update their laws to give pregnant women greater control over what their end-of-life care should look like if they are pregnant.
As an estate planning attorney, I have seen how difficult it can be for clients – especially women – to face the possibility that their medical wishes might not be honored in certain circumstances, such as during pregnancy. Washington’s recent change allows women greater freedom to choose. If you would like to update your health care directive to take this new change into account, please let us know.
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