{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/54.1-2986.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/54.1-2986.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/54.1-2986.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/54.1-2986.html"}],"law_id":65220,"edition_id":1,"section_id":65220,"structure_id":14683,"section_number":"54.1-2986","catch_line":"Procedure in absence of an advance directive; procedure for advance directive without agent; no presumption; persons who may authorize health care for patients incapable of informed decisions","history":"1983, c. 532, \u00a7 54-325.8:6; 1988, c. 765; 1992, cc. 748, 772; 1999, c. 814; 2000, c. 810; 2005, c. 716; 2009, cc. 211, 268; 2010, c. 792.","full_text":"A\n\nWhenever a patient is determined to be incapable of making an informed decision and (i) has not made an advance directive in accordance with this article or (ii) has made an advance directive in accordance with this article that does not indicate his wishes with respect to the health care at issue and does not appoint an agent, the attending physician may, upon compliance with the provisions of this section, provide, continue, withhold or withdraw health care upon the authorization of any of the following persons, in the specified order of priority, if the physician is not aware of any available, willing and capable person in a higher class:1\n\nA guardian for the patient. This subdivision shall not be construed to require such appointment in order that a health care decision can be made under this section; or2\n\nThe patient’s spouse except where a divorce action has been filed and the divorce is not final; or3\n\nAn adult child of the patient; or4\n\nA parent of the patient; or5\n\nAn adult brother or sister of the patient; or6\n\nAny other relative of the patient in the descending order of blood relationship; or7\n\nExcept in cases in which the proposed treatment recommendation involves the withholding or withdrawing of a life-prolonging procedure, any adult, except any director, employee, or agent of a health care provider currently involved in the care of the patient, who (i) has exhibited special care and concern for the patient and (ii) is familiar with the patient’s religious beliefs and basic values and any preferences previously expressed by the patient regarding health care, to the extent that they are known. A quorum of a patient care consulting committee as defined in § 54.1-2982 of the facility where the patient is receiving health care or, if such patient care consulting committee does not exist or if a quorum of such patient care consulting committee is not reasonably available, two physicians who (a) are not currently involved in the care of the patient, (b) are not employed by the facility where the patient is receiving health care, and (c) do not practice medicine in the same professional business entity as the attending physician shall determine whether a person meets these criteria and shall document the information relied upon in making such determination.\n\t\t\t\tIf two or more of the persons listed in the same class in subdivisions A 3 through A 7 with equal decision-making priority inform the attending physician that they disagree as to a particular health care decision, the attending physician may rely on the authorization of a majority of the reasonably available members of that class.B\n\nRegardless of the absence of an advance directive, if the patient has expressed his intent to be an organ donor in any written document, no person noted in this section shall revoke, or in any way hinder, such organ donation.","order_by":null,"text":{"0":{"id":237203,"text":"Whenever a patient is determined to be incapable of making an informed decision and (i) has not made an advance directive in accordance with this article or (ii) has made an advance directive in accordance with this article that does not indicate his wishes with respect to the health care at issue and does not appoint an agent, the attending physician may, upon compliance with the provisions of this section, provide, continue, withhold or withdraw health care upon the authorization of any of the following persons, in the specified order of priority, if the physician is not aware of any available, willing and capable person in a higher class:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":237204,"text":"A guardian for the patient. This subdivision shall not be construed to require such appointment in order that a health care decision can be made under this section; or","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":237205,"text":"The patient’s spouse except where a divorce action has been filed and the divorce is not final; or","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":237206,"text":"An adult child of the patient; or","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"A4"},"4":{"id":237207,"text":"A parent of the patient; or","type":"section","prefixes":["A","4"],"prefix":"4","entire_prefix":"A4","prefix_anchor":"A4","level":2,"prior_prefix":"A3","next_prefix":"A5"},"5":{"id":237208,"text":"An adult brother or sister of the patient; or","type":"section","prefixes":["A","5"],"prefix":"5","entire_prefix":"A5","prefix_anchor":"A5","level":2,"prior_prefix":"A4","next_prefix":"A6"},"6":{"id":237209,"text":"Any other relative of the patient in the descending order of blood relationship; or","type":"section","prefixes":["A","6"],"prefix":"6","entire_prefix":"A6","prefix_anchor":"A6","level":2,"prior_prefix":"A5","next_prefix":"A7"},"7":{"id":237210,"text":"Except in cases in which the proposed treatment recommendation involves the withholding or withdrawing of a life-prolonging procedure, any adult, except any director, employee, or agent of a health care provider currently involved in the care of the patient, who (i) has exhibited special care and concern for the patient and (ii) is familiar with the patient’s religious beliefs and basic values and any preferences previously expressed by the patient regarding health care, to the extent that they are known. A quorum of a patient care consulting committee as defined in § 54.1-2982 of the facility where the patient is receiving health care or, if such patient care consulting committee does not exist or if a quorum of such patient care consulting committee is not reasonably available, two physicians who (a) are not currently involved in the care of the patient, (b) are not employed by the facility where the patient is receiving health care, and (c) do not practice medicine in the same professional business entity as the attending physician shall determine whether a person meets these criteria and shall document the information relied upon in making such determination.\n\t\t\t\tIf two or more of the persons listed in the same class in subdivisions A 3 through A 7 with equal decision-making priority inform the attending physician that they disagree as to a particular health care decision, the attending physician may rely on the authorization of a majority of the reasonably available members of that class.","type":"section","prefixes":["A","7"],"prefix":"7","entire_prefix":"A7","prefix_anchor":"A7","level":2,"prior_prefix":"A6","next_prefix":"B"},"8":{"id":237211,"text":"Regardless of the absence of an advance directive, if the patient has expressed his intent to be an organ donor in any written document, no person noted in this section shall revoke, or in any way hinder, such organ donation.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A7"}},"ancestry":[{"id":14683,"edition_id":1,"name":"Health Care Decisions Act","identifier":"8","label":"article","depth":4,"order_by":1,"parent_id":12759,"metadata":{},"date_created":"2026-06-26 03:49:19","date_modified":"2026-06-26 03:49:19","permalink":{"id":242579,"object_type":"structure","relational_id":14683,"identifier":"8","token":"54.1\/III\/29\/8","url":"\/54.1\/III\/29\/8\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12759,"edition_id":1,"name":"Medicine and Other Healing Arts","identifier":"29","label":"chapter","depth":3,"order_by":1,"parent_id":12758,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":241933,"object_type":"structure","relational_id":12759,"identifier":"29","token":"54.1\/III\/29","url":"\/54.1\/III\/29\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12758,"edition_id":1,"name":"Professions and Occupations Regulated by Boards Within the Department of Health Professions","identifier":"III","label":"subtitle","depth":2,"order_by":1,"parent_id":12754,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":241105,"object_type":"structure","relational_id":12758,"identifier":"III","token":"54.1\/III","url":"\/54.1\/III\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12754,"edition_id":1,"name":"Professions and Occupations","identifier":"54.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":239313,"object_type":"structure","relational_id":12754,"identifier":"54.1","token":"54.1","url":"\/54.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":77307,"structure_id":14683,"section_number":"54.1-2981","catch_line":"Short title","url":"\/54.1-2981\/","token":"54.1\/III\/29\/8\/54.1-2981","metadata":false},{"id":56308,"structure_id":14683,"section_number":"54.1-2982","catch_line":"Definitions","url":"\/54.1-2982\/","token":"54.1\/III\/29\/8\/54.1-2982","metadata":false},{"id":57295,"structure_id":14683,"section_number":"54.1-2983","catch_line":"Procedure for making advance directive; notice to physician","url":"\/54.1-2983\/","token":"54.1\/III\/29\/8\/54.1-2983","metadata":false},{"id":61815,"structure_id":14683,"section_number":"54.1-2983.1","catch_line":"Participation in health care research","url":"\/54.1-2983.1\/","token":"54.1\/III\/29\/8\/54.1-2983.1","metadata":false},{"id":67924,"structure_id":14683,"section_number":"54.1-2983.2","catch_line":"Capacity; required determinations","url":"\/54.1-2983.2\/","token":"54.1\/III\/29\/8\/54.1-2983.2","metadata":false},{"id":56394,"structure_id":14683,"section_number":"54.1-2983.3","catch_line":"Exclusions and limitations of advance directives","url":"\/54.1-2983.3\/","token":"54.1\/III\/29\/8\/54.1-2983.3","metadata":false},{"id":62832,"structure_id":14683,"section_number":"54.1-2984","catch_line":"Suggested form of written advance directives","url":"\/54.1-2984\/","token":"54.1\/III\/29\/8\/54.1-2984","metadata":false},{"id":58882,"structure_id":14683,"section_number":"54.1-2985","catch_line":"Revocation of an advance directive","url":"\/54.1-2985\/","token":"54.1\/III\/29\/8\/54.1-2985","metadata":false},{"id":61746,"structure_id":14683,"section_number":"54.1-2985.1","catch_line":"Injunction; 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burden of proof; presumption","url":"\/54.1-2988\/","token":"54.1\/III\/29\/8\/54.1-2988","metadata":false},{"id":76186,"structure_id":14683,"section_number":"54.1-2988.1","catch_line":"Assistance with completing and executing advance directives","url":"\/54.1-2988.1\/","token":"54.1\/III\/29\/8\/54.1-2988.1","metadata":false},{"id":75997,"structure_id":14683,"section_number":"54.1-2989","catch_line":"Willful destruction, concealment, etc., of declaration or revocation; penalties","url":"\/54.1-2989\/","token":"54.1\/III\/29\/8\/54.1-2989","metadata":false},{"id":63401,"structure_id":14683,"section_number":"54.1-2989.1","catch_line":"Failure to deliver advance directive","url":"\/54.1-2989.1\/","token":"54.1\/III\/29\/8\/54.1-2989.1","metadata":false},{"id":83098,"structure_id":14683,"section_number":"54.1-2990","catch_line":"Medically unnecessary health care not required; procedure when physician refuses to comply with an advance directive or a designated person's health care decision; mercy killing or euthanasia prohibited","url":"\/54.1-2990\/","token":"54.1\/III\/29\/8\/54.1-2990","metadata":false},{"id":78993,"structure_id":14683,"section_number":"54.1-2991","catch_line":"Effect of declaration; suicide; insurance; declarations executed prior to effective date","url":"\/54.1-2991\/","token":"54.1\/III\/29\/8\/54.1-2991","metadata":false},{"id":74741,"structure_id":14683,"section_number":"54.1-2992","catch_line":"Preservation of existing rights","url":"\/54.1-2992\/","token":"54.1\/III\/29\/8\/54.1-2992","metadata":false},{"id":58521,"structure_id":14683,"section_number":"54.1-2993","catch_line":"Reciprocity","url":"\/54.1-2993\/","token":"54.1\/III\/29\/8\/54.1-2993","metadata":false},{"id":76420,"structure_id":14683,"section_number":"54.1-2993.1","catch_line":"Qualified advance directive facilitators; requirements for training programs","url":"\/54.1-2993.1\/","token":"54.1\/III\/29\/8\/54.1-2993.1","metadata":false}],"previous_section":{"id":61746,"structure_id":14683,"section_number":"54.1-2985.1","catch_line":"Injunction; court-ordered health care","url":"\/54.1-2985.1\/","token":"54.1\/III\/29\/8\/54.1-2985.1","metadata":false},"next_section":{"id":79852,"structure_id":14683,"section_number":"54.1-2986.1","catch_line":"Duties and authority of agent or person identified in \u00a7 54.1-2986","url":"\/54.1-2986.1\/","token":"54.1\/III\/29\/8\/54.1-2986.1","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/54.1-2986\/","history_text":"

This law was first created in 1983. The record of its establishment is cataloged in chapter 532 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1983 \u201cActs\u201d aren\u2019t available online. It has been modified 7 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1988, chapter 765; in 1992, chapters 748 and 772; in 1999, chapter 814<\/a>; in 2000, chapter 810<\/a>; in 2005, chapter 716<\/a>; in 2009, chapters 211<\/a> and 268<\/a>; in 2010, chapter 792<\/a>.<\/p>","references":[{"id":85883,"section_number":"32.1-127","catch_line":"(Effective January 1, 2026) Regulations","order_by":null,"url":"\/32.1-127\/"},{"id":69971,"section_number":"32.1-138.1","catch_line":"Implementation of transfer and discharge policies","order_by":null,"url":"\/32.1-138.1\/"},{"id":71942,"section_number":"37.2-817.1","catch_line":"Monitoring and court review of mandatory outpatient treatment","order_by":null,"url":"\/37.2-817.1\/"},{"id":67924,"section_number":"54.1-2983.2","catch_line":"Capacity; required determinations","order_by":null,"url":"\/54.1-2983.2\/"},{"id":62832,"section_number":"54.1-2984","catch_line":"Suggested form of written advance directives","order_by":null,"url":"\/54.1-2984\/"},{"id":79852,"section_number":"54.1-2986.1","catch_line":"Duties and authority of agent or person identified in \u00a7 54.1-2986","order_by":null,"url":"\/54.1-2986.1\/"},{"id":73438,"section_number":"54.1-2986.2","catch_line":"Health care decisions in the event of patient protest","order_by":null,"url":"\/54.1-2986.2\/"},{"id":70254,"section_number":"54.1-2987","catch_line":"Transfer of patient by physician who refuses to comply with advance directive or health care decision","order_by":null,"url":"\/54.1-2987\/"},{"id":78436,"section_number":"54.1-2988","catch_line":"Immunity from liability; burden of proof; presumption","order_by":null,"url":"\/54.1-2988\/"},{"id":83098,"section_number":"54.1-2990","catch_line":"Medically unnecessary health care not required; procedure when physician refuses to comply with an advance directive or a designated person's health care decision; mercy killing or euthanasia prohibited","order_by":null,"url":"\/54.1-2990\/"},{"id":84089,"section_number":"63.2-1605","catch_line":"Protective services for adults by local departments","order_by":null,"url":"\/63.2-1605\/"}],"refers_to":[{"id":56308,"section_number":"54.1-2982","catch_line":"Definitions","order_by":null,"url":"\/54.1-2982\/"}],"permalink":{"id":242617,"object_type":"law","relational_id":65220,"identifier":"54.1-2986","token":"54.1\/III\/29\/8\/54.1-2986","url":"\/54.1-2986\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/54.1-2986\/","token":"54.1\/III\/29\/8\/54.1-2986","dublin_core":{"Title":"Procedure in absence of an advance directive; procedure for advance directive without agent; no presumption; persons who may authorize health care for patients incapable of informed decisions","Type":"Text","Format":"text\/html","Identifier":"\u00a7 54.1-2986","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Whenever a patient is determined to be incapable of making an informed decision<\/span> and (i) has not made an advance directive<\/span> in accordance with this article or (ii) has made an advance directive<\/span> in accordance with this article that does not indicate his wishes with respect to the health care<\/span> at issue<\/span> and does not appoint an agent<\/span>, the attending physician<\/span> may, upon compliance with the provisions of this section, provide, continue, withhold or withdraw health care<\/span> upon the authorization of any of the following persons, in the specified order<\/span> of priority, if the physician is not aware of any available, willing and capable person in a higher class: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> A guardian for the patient. This subdivision shall not be construed to require such appointment in order<\/span> that a health care<\/span> decision can be made under this section; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> The patient’s spouse except where a divorce action has been filed and the divorce is not final; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> An adult child of the patient; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> A parent of the patient; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> An adult brother or sister of the patient; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Any other relative of the patient in the descending order<\/span> of blood relationship; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Except in cases in which the proposed treatment recommendation involves the withholding or withdrawing of a life-prolonging procedure<\/span>, any adult, except any director, employee, or agent<\/span> of a health care<\/span> provider currently involved in the care of the patient, who (i) has exhibited special care and concern for the patient and (ii) is familiar with the patient’s religious beliefs and basic values and any preferences previously expressed by the patient regarding health care<\/span>, to the extent that they are known. A quorum of a patient care consulting committee<\/span> as defined in § 54.1-2982<\/a> of the facility where the patient is receiving health care<\/span> or, if such patient care consulting committee<\/span> does not exist or if a quorum of such patient care consulting committee<\/span> is not reasonably available, two physicians<\/span> who (a) are not currently involved in the care of the patient, (b) are not employed by the facility where the patient is receiving health care<\/span>, and (c) do not practice medicine in the same professional business entity as the attending physician<\/span> shall determine whether a person meets these criteria and shall document the information relied upon in making such determination.\n\t\t\t\tIf two or more of the persons listed in the same class in subdivisions A 3 through A 7 with equal decision-making priority inform the attending physician<\/span> that they disagree as to a particular health care<\/span> decision, the attending physician<\/span> may rely on the authorization of a majority of the reasonably available members of that class. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> Regardless of the absence of an advance directive<\/span>, if the patient has expressed his intent<\/span> to be an organ donor in any written document, no person noted in this section shall revoke, or in any way hinder, such organ donation. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPROCEDURE IN ABSENCE OF AN ADVANCE DIRECTIVE; PROCEDURE FOR ADVANCE DIRECTIVE\nWITHOUT AGENT; NO PRESUMPTION; PERSONS WHO MAY AUTHORIZE HEALTH CARE FOR\nPATIENTS INCAPABLE OF INFORMED DECISIONS (\u00a7 54.1-2986)\n\nA. Whenever a patient is determined to be incapable of making an informed\ndecision and (i) has not made an advance directive in accordance with this\narticle or (ii) has made an advance directive in accordance with this article\nthat does not indicate his wishes with respect to the health care at issue and\ndoes not appoint an agent, the attending physician may, upon compliance with the\nprovisions of this section, provide, continue, withhold or withdraw health care\nupon the authorization of any of the following persons, in the specified order\nof priority, if the physician is not aware of any available, willing and capable\nperson in a higher class:\n\n 1. A guardian for the patient. This subdivision shall not be construed to\n require such appointment in order that a health care decision can be made\n under this section; or\n\n 2. The patient’s spouse except where a divorce action has been filed and\n the divorce is not final; or\n\n 3. An adult child of the patient; or\n\n 4. A parent of the patient; or\n\n 5. An adult brother or sister of the patient; or\n\n 6. Any other relative of the patient in the descending order of blood\n relationship; or\n\n 7. Except in cases in which the proposed treatment recommendation involves the\n withholding or withdrawing of a life-prolonging procedure, any adult, except\n any director, employee, or agent of a health care provider currently involved\n in the care of the patient, who (i) has exhibited special care and concern for\n the patient and (ii) is familiar with the patient’s religious beliefs\n and basic values and any preferences previously expressed by the patient\n regarding health care, to the extent that they are known. A quorum of a\n patient care consulting committee as defined in § 54.1-2982 of the\n facility where the patient is receiving health care or, if such patient care\n consulting committee does not exist or if a quorum of such patient care\n consulting committee is not reasonably available, two physicians who (a) are\n not currently involved in the care of the patient, (b) are not employed by the\n facility where the patient is receiving health care, and (c) do not practice\n medicine in the same professional business entity as the attending physician\n shall determine whether a person meets these criteria and shall document the\n information relied upon in making such determination.\n \t\t\t\tIf two or more of the persons listed in the same class in subdivisions A 3\n through A 7 with equal decision-making priority inform the attending physician\n that they disagree as to a particular health care decision, the attending\n physician may rely on the authorization of a majority of the reasonably\n available members of that class.\n\nB. Regardless of the absence of an advance directive, if the patient has\nexpressed his intent to be an organ donor in any written document, no person\nnoted in this section shall revoke, or in any way hinder, such organ donation.\n\nHISTORY: 1983, c. 532, \u00a7 54-325.8:6; 1988, c. 765; 1992, cc. 748, 772; 1999, c.\n814; 2000, c. 810; 2005, c. 716; 2009, cc. 211, 268; 2010, c. 792.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}