                                 CODE OF VIRGINIA

DEFINITIONS (§ 54.1-2982)

As used in this article:
		&#8220;Advance directive&#8221; 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.
		&#8220;Agent&#8221; 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&#8217;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.
		&#8220;Attending physician&#8221; means the primary physician who has
responsibility for the health care of the patient.
		&#8220;Capacity reviewer&#8221; 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.
		&#8220;Declarant&#8221; means an adult who makes an advance directive, as
defined in this article, while capable of making and communicating an informed
decision.
		&#8220;Durable Do Not Resuscitate Order&#8221; means a written
physician&#8217;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 &#8220;advance directive&#8221; and
&#8220;Durable Do Not Resuscitate Order&#8221; are used in this article, a
Durable Do Not Resuscitate Order is not and shall not be construed as an advance
directive.
		&#8220;Health care&#8221; 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.
		&#8220;Health care provider&#8221; shall have the same meaning as provided in
§ 8.01-581.1.
		&#8220;Incapable of making an informed decision&#8221; 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.
		&#8220;Life-prolonging procedure&#8221; 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.
		&#8220;Patient care consulting committee&#8221; 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.
		&#8220;Persistent vegetative state&#8221; 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.
		&#8220;Physician&#8221; 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.
		&#8220;Qualified advance directive facilitator&#8221; 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.
		&#8220;Terminal condition&#8221; 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&#8217;s death is imminent or (ii) the patient
is in a persistent vegetative state.
		&#8220;Witness&#8221; means any person over the age of 18, including a spouse
or blood relative of the declarant. Employees of health care facilities and
physician&#8217;s offices, who act in good faith, shall be permitted to serve as
witnesses for purposes of this article.

HISTORY: 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.