                                 CODE OF VIRGINIA

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 (§ 54.1-2986)

A. 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:

   1. 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

   2. The patient&#8217;s spouse except where a divorce action has been filed and
   the divorce is not final; or

   3. An adult child of the patient; or

   4. A parent of the patient; or

   5. An adult brother or sister of the patient; or

   6. Any other relative of the patient in the descending order of blood
   relationship; or

   7. 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&#8217;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 &#xA7; 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.
   				If 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. 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.

HISTORY: 1983, c. 532, § 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.