Now, every state has a Natural DeathAct explicitly allowing patients to refuse excessive medical care at the end of life. In addition, the Natural Death Acts in some states, such as Washingtion , specifically state that “physicians and nurses should not withhold or unreason ably diminish pain medication for patients in a terminal condition where the primary intent of providing such medication is to alleviate pain and maintain or unreasonably diminish pain medication for patients in a terminal condition where the primary intent of providing such medication is to alleviate pain and maintain or increase the patient’s comfort” [1992 c 98 1 ; 1997 c 112 2.].finally, most states also include in their Natural Death Act a provision that a person’s right to control his or her healthcare may be exercised by an authorized representative who validly holds the person’s durable power of attorney for healthcare