Virginia Code 54.1-2986.2: Health care decisions in the event of patient protest.
A. Except as provided in subsection B or C, the provisions of this article shall not authorize providing, continuing, withholding or withdrawing health care if the patient’s attending physician knows that such action is protested by the patient.
Terms Used In Virginia Code 54.1-2986.2
- Advance directive: means (i) a witnessed written document, voluntarily executed by the declarant in accordance with the requirements of § Virginia Code 54.1-2982
- Advanced practice registered nurse: means a certified nurse midwife, certified registered nurse anesthetist, clinical nurse specialist, or nurse practitioner who is jointly licensed by the Boards of Medicine and Nursing pursuant to § Virginia Code 54.1-2900
- Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
- Agent: means an adult appointed by the declarant under an advance directive, executed or made in accordance with the provisions of § Virginia Code 54.1-2982
- Attending physician: means the primary physician who has responsibility for the health care of the patient. See Virginia Code 54.1-2982
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Health care: means the furnishing of services to any individual for the purpose of preventing, alleviating, curing, or healing human illness, injury or physical disability, including but not limited to, medications; surgery; blood transfusions; chemotherapy; radiation therapy; admission to a hospital, nursing home, assisted living facility, or other health care facility; psychiatric or other mental health treatment; and life-prolonging procedures and palliative care. See Virginia Code 54.1-2982
- in writing: include any representation of words, letters, symbols, numbers, or figures, whether (i) printed or inscribed on a tangible medium or (ii) stored in an electronic or other medium and retrievable in a perceivable form and whether an electronic signature authorized by Virginia Code 1-257
- Incapable of making an informed decision: means the inability of an adult patient, because of mental illness, intellectual disability, or any other mental or physical disorder that precludes communication or impairs judgment, to make an informed decision about providing, continuing, withholding or withdrawing a specific health care treatment or course of treatment because he is unable to understand the nature, extent or probable consequences of the proposed health care decision, or to make a rational evaluation of the risks and benefits of alternatives to that decision. See Virginia Code 54.1-2982
- Patient care consulting committee: means a committee duly organized by a facility licensed to provide health care under Virginia Code 54.1-2982
- Person: includes any individual, corporation, partnership, association, cooperative, limited liability company, trust, joint venture, government, political subdivision, or any other legal or commercial entity and any successor, representative, agent, agency, or instrumentality thereof. See Virginia Code 1-230
- Physician: means a person licensed to practice medicine in the Commonwealth of Virginia or in the jurisdiction where the health care is to be rendered or withheld. See Virginia Code 54.1-2982
- Physician assistant: means a health care professional who has met the requirements of the Board for licensure as a physician assistant. See Virginia Code 54.1-2900
B. A patient’s agent may make a health care decision over the protest of a patient who is incapable of making an informed decision if:
1. The patient’s advance directive explicitly authorizes the patient’s agent to make the health care decision at issue, even over the patient’s later protest, and an attending licensed physician, a licensed clinical psychologist, a licensed physician assistant, a licensed advanced practice registered nurse, a licensed professional counselor, or a licensed clinical social worker who is familiar with the patient attested in writing at the time the advance directive was made that the patient was capable of making an informed decision and understood the consequences of the provision;
2. The decision does not involve withholding or withdrawing life-prolonging procedures; and
3. The health care that is to be provided, continued, withheld or withdrawn is determined and documented by the patient’s attending physician to be medically appropriate and is otherwise permitted by law.
C. In cases in which a patient has not explicitly authorized his agent to make the health care decision at issue over the patient’s later protest, a patient’s agent or person authorized to make decisions pursuant to § 54.1-2986 may make a decision over the protest of a patient who is incapable of making an informed decision if:
1. The decision does not involve withholding or withdrawing life-prolonging procedures;
2. The decision does not involve (i) admission to a facility as defined in § 37.2-100 or (ii) treatment or care that is subject to regulations adopted pursuant to § 37.2-400;
3. The health care decision is based, to the extent known, on the patient’s religious beliefs and basic values and on any preferences previously expressed by the patient in an advance directive or otherwise regarding such health care or, if they are unknown, is in the patient’s best interests;
4. The health care that is to be provided, continued, withheld, or withdrawn has been determined and documented by the patient’s attending physician to be medically appropriate and is otherwise permitted by law; and
5. The health care that is to be provided, continued, withheld, or withdrawn has been affirmed and documented as being ethically acceptable by the health care facility’s patient care consulting committee, if one exists, or otherwise by two physicians not currently involved in the patient’s care or in the determination of the patient’s capacity to make health care decisions.
D. A patient’s protest shall not revoke the patient’s advance directive unless it meets the requirements of § 54.1-2985.
E. If a patient protests the authority of a named agent or any person authorized to make health care decisions by § 54.1-2986, except for the patient’s guardian, the protested individual shall have no authority under this article to make health care decisions on his behalf unless the patient’s advance directive explicitly confers continuing authority on his agent, even over his later protest. If the protested individual is denied authority under this subsection, authority to make health care decisions shall be determined by any other provisions of the patient’s advance directive, or in accordance with § 54.1-2986 or in accordance with any other provision of law.
2009, cc. 211, 268; 2010, c. 792; 2017, cc. 456, 474; 2023, c. 183.