                                 CODE OF VIRGINIA

HEALTH CARE DECISIONS IN THE EVENT OF PATIENT PROTEST (§ 54.1-2986.2)

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&#8217;s attending physician knows that such action is protested by
the patient.

B. A patient&#8217;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&#8217;s advance directive explicitly authorizes the
   patient&#8217;s agent to make the health care decision at issue, even over the
   patient&#8217;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 The health care that is to be provided, continued, withheld or withdrawn is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&#8217;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&#8217;s later protest, a
patient&#8217;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
   &#xA7; 37.2-100 or (ii) treatment or care that is subject to regulations
   adopted pursuant to &#xA7; 37.2-400;

   3. The health care decision is based, to the extent known, on the
   patient&#8217;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&#8217;s
   best interests;

   4. The health care that is to be provided, continued, withheld, or withdrawn
   has been determined and documented by the patient&#8217;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&#8217;s patient care consulting committee, if one exists, or
   otherwise by two physicians not currently involved in the patient&#8217;s care
   or in the determination of the patient&#8217;s capacity to make health care
   decisions.

D. A patient&#8217;s protest shall not revoke the patient&#8217;s advance
directive unless it meets the requirements of &#xA7; 54.1-2985.

E. If a patient protests the authority of a named agent or any person authorized
to make health care decisions by &#xA7; 54.1-2986, except for the
patient&#8217;s guardian, the protested individual shall have no authority under
this article to make health care decisions on his behalf unless the
patient&#8217;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&#8217;s advance directive,
or in accordance with &#xA7; 54.1-2986 or in accordance with any other provision
of law.

HISTORY: 2009, cc. 211, 268; 2010, c. 792; 2017, cc. 456, 474; 2023, c. 183.