As used in this article:
"Advance directive" means (i) a witnessed written document, voluntarily executed by the declarant in accordance with the requirements of § 54.1-2983 or (ii) a witnessed oral statement, made by the declarant subsequent to the time he is diagnosed as suffering from a terminal condition and in accordance with the provisions of § 54.1-2983.
"Agent" means an adult appointed by the declarant under an advance directive, executed or made in accordance with the provisions of § 54.1-2983, to make health care decisions for him. The declarant may also appoint an adult to make, after the declarant's death, an anatomical gift of all or any part of his body pursuant to Article 2 (§ 32.1-291.1 et seq.) of Chapter 8 of Title 32.1.
"Attending physician" means the primary physician who has responsibility for the health care of the patient.
"Capacity reviewer" means a licensed physician or clinical psychologist who is qualified by training or experience to assess whether a person is capable or incapable of making an informed decision.
"Declarant" means an adult who makes an advance directive, as defined in this article, while capable of making and communicating an informed decision.
"Durable Do Not Resuscitate Order" means a written physician's order issued pursuant to § 54.1-2987.1 to withhold cardiopulmonary resuscitation from a particular patient in the event of cardiac or respiratory arrest. For purposes of this article, cardiopulmonary resuscitation shall include cardiac compression, endotracheal intubation and other advanced airway management, artificial ventilation, and defibrillation and related procedures. As the terms "advance directive" and "Durable Do Not Resuscitate Order" are used in this article, a Durable Do Not Resuscitate Order is not and shall not be construed as an advance directive.
"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.
"Health care provider" shall have the same meaning as provided in § 8.01-581.1.
"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. For purposes of this article, persons who are deaf, dysphasic or have other communication disorders, who are otherwise mentally competent and able to communicate by means other than speech, shall not be considered incapable of making an informed decision.
"Life-prolonging procedure" means any medical procedure, treatment or intervention which (i) utilizes mechanical or other artificial means to sustain, restore or supplant a spontaneous vital function, or is otherwise of such a nature as to afford a patient no reasonable expectation of recovery from a terminal condition and (ii) when applied to a patient in a terminal condition, would serve only to prolong the dying process. The term includes artificially administered hydration and nutrition. However, nothing in this act shall prohibit the administration of medication or the performance of any medical procedure deemed necessary to provide comfort care or to alleviate pain, including the administration of pain relieving medications in excess of recommended dosages in accordance with §§ 54.1-2971.01 and 54.1-3408.1. For purposes of §§ 54.1-2988, 54.1-2989, and 54.1-2991, the term also shall include cardiopulmonary resuscitation.
"Patient care consulting committee" means a committee duly organized by a facility licensed to provide health care under Title 32.1 or Title 37.2, or a hospital or nursing home as defined in § 32.1-123 owned or operated by an agency of the Commonwealth that is exempt from licensure pursuant to § 32.1-124, to consult on health care issues only as authorized in this article. Each patient care consulting committee shall consist of five individuals, including at least one physician, one person licensed or holding a multistate licensure privilege under Chapter 30 (§ 54.1-3000 et seq.) to practice professional nursing, and one individual responsible for the provision of social services to patients of the facility. At least one committee member shall have experience in clinical ethics and at least two committee members shall have no employment or contractual relationship with the facility or any involvement in the management, operations, or governance of the facility, other than serving on the patient care consulting committee. A patient care consulting committee may be organized as a subcommittee of a standing ethics or other committee established by the facility or may be a separate and distinct committee. Four members of the patient care consulting committee shall constitute a quorum of the patient care consulting committee.
"Persistent vegetative state" means a condition caused by injury, disease or illness in which a patient has suffered a loss of consciousness, with no behavioral evidence of self-awareness or awareness of surroundings in a learned manner, other than reflex activity of muscles and nerves for low level conditioned response, and from which, to a reasonable degree of medical probability, there can be no recovery.
"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.
"Qualified advance directive facilitator" means a person who has successfully completed a training program approved by the Department of Health for providing assistance in completing and executing a written advance directive, including successful demonstration of competence in assisting a person in completing and executing a valid advance directive and successful passage of a written examination.
"Terminal condition" means a condition caused by injury, disease or illness from which, to a reasonable degree of medical probability a patient cannot recover and (i) the patient's death is imminent or (ii) the patient is in a persistent vegetative state.
"Witness" means any person over the age of 18, including a spouse or blood relative of the declarant. Employees of health care facilities and physician's offices, who act in good faith, shall be permitted to serve as witnesses for purposes of this article.
1983, c. 532, § 54-325.8:2; 1984, c. 79; 1988, c. 765; 1991, c. 583; 1992, cc. 412, 748, 772; 1994, c. 956; 1997, c. 609; 1998, cc. 630, 803, 854; 1999, c. 814; 2000, c. 1034; 2005, c. 186; 2007, cc. 92, 907; 2009, cc. 211, 268; 2010, c. 792; 2012, cc. 476, 507; 2017, cc. 747, 752; 2021, Sp. Sess. I, c. 465.
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