A. As used in this section, "autonomous nurse practitioner" means a nurse practitioner who is authorized to practice without a practice agreement pursuant to subsection I of § 54.1-2957.
B. A person shall be medically and legally dead if:
1. In the opinion of a physician duly authorized to practice medicine in the Commonwealth or autonomous nurse practitioner, based on the ordinary standards of medical practice, there is the absence of spontaneous respiratory and spontaneous cardiac functions and, because of the disease or condition that directly or indirectly caused these functions to cease, or because of the passage of time since these functions ceased, attempts at resuscitation would not, in the opinion of such physician or autonomous nurse practitioner, be successful in restoring spontaneous life-sustaining functions, and, in such event, death shall be deemed to have occurred at the time these functions ceased; or
2. In the opinion of a physician, who shall be duly licensed to practice medicine in the Commonwealth and board-eligible or board-certified in the field of neurology, neurosurgery, or critical care medicine, when based on the ordinary standards of medical practice, there is irreversible cessation of all functions of the entire brain, including the brain stem, and, in the opinion of such physician, based on the ordinary standards of medical practice and considering the irreversible cessation of all functions of the entire brain, including the brain stem, and the patient's medical record, further attempts at resuscitation or continued supportive maintenance would not be successful in restoring such functions, and, in such event, death shall be deemed to have occurred at the time when all such functions have ceased.
C. A registered nurse, physician assistant, or nurse practitioner who is not an autonomous nurse practitioner may pronounce death if the following criteria are satisfied: (i) the nurse is employed by or the physician assistant or nurse practitioner who is not an autonomous nurse practitioner works at (a) a home care organization as defined in § 32.1-162.7, (b) a hospice as defined in § 32.1-162.1, (c) a hospital or nursing home as defined in § 32.1-123, including state-operated hospitals for the purposes of this section, (d) the Department of Corrections, or (e) a continuing care retirement community registered with the State Corporation Commission pursuant to Chapter 49 (§ 38.2-4900 et seq.) of Title 38.2; (ii) the nurse, physician assistant, or nurse practitioner who is not an autonomous nurse practitioner is directly involved in the care of the patient; (iii) the patient's death has occurred; (iv) the patient is under the care of a physician or autonomous nurse practitioner when his death occurs; (v) the patient's death has been anticipated; and (vi) the physician or autonomous nurse practitioner is unable to be present within a reasonable period of time to determine death. A licensed practical nurse may pronounce death for a patient in hospice pursuant to a valid Do Not Resuscitate Order issued in accordance with § 54.1-2987.1. The nurse, licensed practical nurse, physician assistant, or nurse practitioner who is not an autonomous nurse practitioner shall inform the patient's attending and consulting physician or autonomous nurse practitioner of the patient's death as soon as practicable.
The nurse, licensed practical nurse, physician assistant, or nurse practitioner who is not an autonomous nurse practitioner shall have the authority to pronounce death in accordance with such procedural regulations, if any, as may be promulgated by the Board of Medicine; however, if the circumstances of the death are not anticipated or the death requires an investigation by the Office of the Chief Medical Examiner, such nurse, licensed practical nurse, physician assistant, or nurse practitioner shall notify the Office of the Chief Medical Examiner of the death and the body shall not be released to the funeral director.
This subsection shall not authorize a nurse, licensed practical nurse, physician assistant, or nurse practitioner who is not an autonomous nurse practitioner to determine the cause of death. Determination of cause of death shall continue to be the responsibility of the attending physician or autonomous nurse practitioner, except as provided in § 32.1-263. Further, this subsection shall not be construed to impose any obligation to carry out the functions of this subsection.
This subsection shall not relieve any registered nurse, licensed practical nurse, physician assistant, or nurse practitioner who is not an autonomous nurse practitioner from any civil or criminal liability that might otherwise be incurred for failure to follow statutes or Board of Nursing or Board of Medicine regulations.
D. The alternative definitions of death provided in subdivisions B 1 and 2 may be utilized for all purposes in the Commonwealth, including the trial of civil and criminal cases.
Code 1950, § 32-364.3:1; 1973, c. 252; 1979, c. 720, § 54-325.7; 1986, c. 237; 1988, c. 765; 1996, c. 1028; 1997, cc. 107, 453; 2002, c. 92; 2004, c. 92; 2010, c. 46; 2011, c. 613; 2012, c. 136; 2014, cc. 73, 583; 2016, c. 97; 2021, Sp. Sess. I, c. 210; 2022, cc. 184, 198.
Structure Code of Virginia
Title 54.1 - Professions and Occupations
Chapter 29 - Medicine and Other Healing Arts
§ 54.1-2901. Exceptions and exemptions generally
§ 54.1-2902. Unlawful to practice without license
§ 54.1-2903. What constitutes practice; advertising in connection with medical practice
§ 54.1-2904. Biennial renewal of licenses; copies; fee; lapsed licenses; reinstatement; penalties
§ 54.1-2909. Further reporting requirements; civil penalty; disciplinary action
§ 54.1-2910.01. Practitioner information provided to patients
§ 54.1-2910.1. Certain data required
§ 54.1-2910.2. Posting of disciplinary information
§ 54.1-2910.3. No requirement to participate in third-party reimbursement programs
§ 54.1-2910.3:1. Medicaid recipients; treatment involving prescription of opioids; payment
§ 54.1-2910.4. Health record retention
§ 54.1-2910.5. (Effective July 1, 2023) Pediatric sexual assault survivor services; requirements
§ 54.1-2911. Board; membership; terms of office; change of residence; executive director; etc.
§ 54.1-2912.1. Continued competency and office-based anesthesia requirements
§ 54.1-2912.2. Board may endorse certain document
§ 54.1-2912.3. Competency assessments of certain practitioners
§ 54.1-2912.4. Board to post autism information
§ 54.1-2913.1. Acceptance of other examinations
§ 54.1-2915. Unprofessional conduct; grounds for refusal or disciplinary action
§ 54.1-2918. Suspension or revocation for violation of facility licensing laws
§ 54.1-2925. Use of experts in disciplinary proceedings
§ 54.1-2926. Powers of Board with respect to practitioners licensed to practice pharmacy
§ 54.1-2928.1. Restricted volunteer license
§ 54.1-2928.2. Board to adopt regulations related to prescribing of opioids and buprenorphine
§ 54.1-2929. Licenses required
§ 54.1-2930. Requirements for licensure
§ 54.1-2931. Examinations; passing grade
§ 54.1-2932. Issuance of licenses to practice
§ 54.1-2933.1. Temporary licensure of certain foreign graduates to obtain training
§ 54.1-2934. Evidence of right to practice required of certain foreign graduates
§ 54.1-2936. Limited licenses to certain graduates of foreign medical schools
§ 54.1-2937. Temporary licenses to interns and residents in hospitals and other organizations
§ 54.1-2937.1. Retiree license
§ 54.1-2939. Surgery by podiatrists on patients under general anesthesia limited
§ 54.1-2950. Requisite training and educational achievements of assistants
§ 54.1-2950.1. Advisory Board on Physician Assistants; membership; qualifications
§ 54.1-2951.2. Issuance of a license
§ 54.1-2951.3. Restricted volunteer license for certain physician assistants
§ 54.1-2951.4. Exception to physician assistant license requirement; physician assistant student
§ 54.1-2952.2. When physician assistant signature accepted
§ 54.1-2953. Renewal, revocation, suspension, and refusal
§ 54.1-2954. Respiratory therapist; definition
§ 54.1-2954.1. Powers of Board concerning respiratory care
§ 54.1-2955. Restriction of titles
§ 54.1-2956. Advisory Board on Respiratory Care; appointment; terms; duties; etc.
§ 54.1-2956.01. Exceptions to respiratory therapist's licensure
§ 54.1-2956.1. Powers of Board concerning occupational therapy
§ 54.1-2956.2. Advisory Board of Occupational Therapy
§ 54.1-2956.3. Advisory Board of Occupational Therapy; composition; appointment
§ 54.1-2956.4. Advisory Board of Occupational Therapy; powers
§ 54.1-2956.5. Unlawful to practice occupational therapy without license
§ 54.1-2956.8. Advisory Board on Radiological Technology; appointments; terms; etc.
§ 54.1-2956.10. Requisite training and educational achievements of acupuncturists
§ 54.1-2956.11. Advisory Board on Acupuncture; composition; appointment
§ 54.1-2956.12. Registered surgical technologist; use of title; registration
§ 54.1-2956.13. Licensure of surgical assistant; practice of surgical assisting; use of title
§ 54.1-2956.14. Advisory Board on Surgical Assisting; appointments; terms; duties
§ 54.1-2957. Licensure and practice of nurse practitioners
§ 54.1-2957.001. Restricted volunteer license for nurse practitioners
§ 54.1-2957.02. When nurse practitioner signature accepted
§ 54.1-2957.03. Certified nurse midwives; required disclosures; liability
§ 54.1-2957.6. Exceptions to athletic trainer licensure
§ 54.1-2957.7. Licensed midwife and practice of midwifery; definitions
§ 54.1-2957.8. Licensure of midwives; requisite training and educational requirements; fees
§ 54.1-2957.9. Regulation of the practice of midwifery
§ 54.1-2957.10. Advisory Board on Midwifery established; membership; duties; terms
§ 54.1-2957.11. Requirements for disclosure
§ 54.1-2957.14. Advisory Board on Polysomnographic Technology; appointment; terms; duties
§ 54.1-2957.15. Unlawful to practice as a polysomnographic technologist without a license
§ 54.1-2957.17. Exceptions to licensure requirements
§ 54.1-2957.18. Advisory Board on Behavior Analysis
§ 54.1-2957.22. Advisory Board on Genetic Counseling established; membership; terms
§ 54.1-2960. Medical students in hospitals
§ 54.1-2961. Interns and residents in hospitals
§ 54.1-2962. Division of fees among physicians prohibited
§ 54.1-2962.01. Anatomic pathology services; fees
§ 54.1-2962.1. Solicitation or receipt of remuneration in exchange for referral prohibited
§ 54.1-2962.2. Physician-patient relationship; effect of certain emergency department treatment
§ 54.1-2963. Selling vitamins or food supplements in connection with a practice of the healing arts
§ 54.1-2963.1. Disclosure of medical treatment options
§ 54.1-2964. Disclosure of interest in referral facilities and clinical laboratories
§ 54.1-2967. Physicians and others rendering medical aid to report certain wounds
§ 54.1-2968. Information about certain handicapped persons
§ 54.1-2969. Authority to consent to surgical and medical treatment of certain minors
§ 54.1-2970. Medical treatment for certain persons incapable of giving informed consent
§ 54.1-2971.01. Prescription in excess of recommended dosage in certain cases
§ 54.1-2971.1. Disclosure for certain treatment of infertility
§ 54.1-2973. Persons who may authorize postmortem examination of decedent's body
§ 54.1-2973.1. Practice of laser hair removal
§ 54.1-2974. Sterilization operations for persons 18 years or older capable of informed consent
§ 54.1-2975. Sterilization operations for certain children incapable of informed consent
§ 54.1-2976. Sterilization operations for certain adults incapable of informed consent
§ 54.1-2977. Standards for court-authorized sterilization of certain persons
§ 54.1-2978. Reports of certain sterilizations
§ 54.1-2979. No liability for nonnegligent performance of operation
§ 54.1-2980. Article inapplicable to certain medical or surgical treatment
§ 54.1-2983. Procedure for making advance directive; notice to physician
§ 54.1-2983.1. Participation in health care research
§ 54.1-2983.2. Capacity; required determinations
§ 54.1-2983.3. Exclusions and limitations of advance directives
§ 54.1-2984. Suggested form of written advance directives
§ 54.1-2985. Revocation of an advance directive
§ 54.1-2985.1. Injunction; court-ordered health care
§ 54.1-2986.1. Duties and authority of agent or person identified in § 54.1-2986
§ 54.1-2986.2. Health care decisions in the event of patient protest
§ 54.1-2987.1. Durable Do Not Resuscitate Orders
§ 54.1-2988. Immunity from liability; burden of proof; presumption
§ 54.1-2988.1. Assistance with completing and executing advance directives
§ 54.1-2989. Willful destruction, concealment, etc., of declaration or revocation; penalties
§ 54.1-2989.1. Failure to deliver advance directive
§ 54.1-2992. Preservation of existing rights
§ 54.1-2993.1. Qualified advance directive facilitators; requirements for training programs
§ 54.1-2994. Advance Health Care Directive Registry established
§ 54.1-2995. Filing of documents with the registry; regulations; fees
§ 54.1-2996. Validity of unregistered documents
§ 54.1-2997. Direct primary care agreements
§ 54.1-2998. Direct primary care agreement requirements; disclosures; disclaimer