This is an adapted excerpt from the Handbook for Washington Seniors: Legal Rights and Resources.
The full Handbook is available to download for free, or you can purchase a print version for $20.

​Preparing in advance for the end of your life can be very helpful for your family members and can help make sure that your wishes are carried out. Your preparation should include gathering updated personal information and important documents in one place, and writing a “Letter of Instruction” or “Final Instructions” letter, which you should give to a family member or friend. This letter can list your after-death plans, including naming someone to be your “Designated Agent” to carry out your plans, and sharing the location of your important documents. Be sure to discuss your plans with family or friends closest to you, so they will understand all of your instructions. For more information, see the People’s Memorial Association, listed in the Resources at the end of this publication, and the Legal Voice publication Life and Death Planning – A Checklist. 

Funerals, Burial, and Organ Donation

What Funeral Plans Should I Consider Making? 

There are a number of decisions you can make when you are pre-planning your funeral. For example, you can decide if you want a funeral or memorial service; write your own obituary; choose the flowers, the music, the readings, and other personal touches; decide if you want to be buried or cremated; and choose your final resting place. Planning in advance lets you compare funeral services and prices, and helps ease the burden on your family and friends.

The federal government and State of Washington have laws that funeral service providers must follow. For example, itemized price information must be given over the telephone, and if you meet in person, prices must be confirmed in writing upon request. Also, you do not have to purchase a package that includes items you do not want (such as a casket or a memorial service). This “Funeral Rule” is enforced by the Federal Trade Commission. For more information, see the listings under “Funerals and Planning” in Resources at the end of this publication.

If you are a Washington State resident, you can sign a “Disposition Authorization” form to legally choose burial or cremation, and a “Designated Agent” form to name the person you want to carry out your after-death plans. You must sign these documents in front of a witness. You can get these forms from the People’s Memorial Association or End of Life Washington (listed under Resources), or your lawyer can prepare the necessary documents. If you do not complete these forms, Washington state law allows a surviving spouse or state registered domestic partner to make these after-death decisions for you. If you do not have a surviving spouse or state registered domestic partner, this responsibility then goes to your adult children, then parents, then siblings. For more information, see the “Funerals, Burials, and Cremation” section of the Dealing with Death chapter in the Handbook for Washington Seniors. 

Note: If your spouse is your agent and you divorce, he or she will automatically no longer be your agent unless special arrangements are made. See the “Divorce” section of the Family Relationships chapter in the Handbook for Washington Seniors.

If you are a veteran or veteran’s family member, you may be eligible for free burial, burial in a veteran’s cemetery, and other benefits. You can preregister and get more information at the Washington State Department of Veterans Affairs office. See the listings under “Veteran’s Burial and Benefits” in Resources. 

Be sure you explain all of your after-death plans to your family or close friends. One way is by writing a “Letter of Instruction” or “Final Instructions” letter. You could also choose a funeral home and pre-plan all the details of your funeral or memorial. Or, you could become a member of a nonprofit memorial society, which can help with many of these types of pre-planning issues.

You do not need to pay in advance for your after-death plans, though it is wise to have enough money set aside to pay for the type of services you want. If you qualify for Medicaid, Washington State allows you to set aside $1,500 for a burial, which should be in a separate bank account called a “Pay on Death” account. After your death, this money will be given to the person you have chosen to take care of your after-death arrangements. Also, a Washington State Funeral Directors Association program called the Washington Master Trust helps with prepaid burial plans. Ask the planning counselor at your chosen funeral home for more information.

How Do I Donate My Organs and Tissue?

Anyone can be a donor regardless of age, race, or medical history. Register with Washington State when you renew your driver’s license or identity card. You can also register by phone or on the Internet. A red heart symbol will show on your card that you are an organ and/or tissue donor. Be sure to tell your family and doctor that you are an organ/tissue donor, and also include this important information in your letter of Final Instructions. See the listings under “Organ and Tissue Donation” in Resources.

Death with Dignity Act

What Is the “Death with Dignity Act”? 

The Washington Death with Dignity Act allows a “qualified” terminally ill adult who wants the option to end his or her life to request life-ending medication from a medical doctor in Washington. “Terminally ill” means you have less than six months to live.

Who Can Request this Medication?

To be a qualified patient, you must be a mentally competent adult and a Washington state resident. You must be diagnosed by two medical doctors (usually your primary care or “attending” doctor, and a second “consulting” doctor) to have less than six months to live. Finally, you must be able to take the drug yourself, and voluntarily state your wish to die both verbally and in writing. 

How Do I Make Requests for the Medication?

If you are a qualified terminally ill patient, you must verbally ask your attending doctor two times before you can receive a prescription for life-ending medication. The second request must be at least 15 days after the first request. Any time after you have seen both the attending and consulting doctors, you must also complete a “Written Request for Medication” form, which must be signed by two witnesses and given to your attending doctor. 

After the 15-day waiting period ends, and at least 48 hours has passed since you gave the written request to your attending doctor, your doctor can write the prescription for life-ending medication. For more information on procedures and for the Written Request for Medication form, see listings under “Death with Dignity Act” in Resources at the end of this publication.

Does My Doctor or Pharmacist Have to Participate, or Be with Me, When I Take the Medication?

No, health care providers are not required to provide prescriptions or medications to qualified patients. They are also not required to be with you when you take the medication. To find a supportive hospital or health system in Washington, see End of Life Washington’s online tool.

Who Should I Tell About My Decision?

That is a very personal choice. Your doctor does not have to tell anyone about your decision. However, your doctor must recommend that you tell your family and friends. For issues to consider, see the publication Talking to Your Family About Dying, by End of Life Washington.

Will My Life Insurance or Annuity Policy Be Void?

No, the Death with Dignity Act states that if you are a qualified terminally ill patient and you take life-ending medication, it will not affect your life insurance, health insurance, accident insurance or annuity policy.

What Else Should I Know About the Death with Dignity Act?

Finding two doctors who are willing to participate can be difficult, especially if you live in Central or Eastern Washington. The process usually takes from four to six weeks after you have received the diagnosis of terminal illness from two doctors.