Virginia Advance Directives
You are the expert on your health care. Nobody knows your health history, your support system, what works for you, and what doesn’t work for you, better than you. An Advance Directive helps you to make sure that you are able to have some control over your future treatment, even if you are unable to make informed decisions for yourself at that time.
An AD allows you to choose who will be making decisions for you
If there comes a time when you are in the hospital and are unable to make decisions for yourself, whether because of injury or illness, your doctor will look to find someone to make treatment decisions for you. Virginia law has a list of people in a specific order that doctors must go through until they find someone who can make these important decisions:
- Court-appointed guardian (if you have one)
- Spouse
- Adult child(ren) (majority rules)
- Parent
- Adult siblings (majority rules)
- Other relatives, in order of blood relationship
- An interested adult, or “next friend”
(For more information about this list of substitute decision-makers, see Va. Code §54.1-2986.)
Some people may feel that the order of the people on this list works well for them, while others do not want these people making decisions for them. By choosing someone to make decisions for you in your Advance Directive (called, “appointing an agent”), your doctor will automatically ask that person to make decisions for you before asking anyone else.
Some situations that may lead people to want to appoint an agent in their AD, instead of having the automatic list above applied to them, include:
- You are separated from your spouse, but are not divorced – under Virginia law, your spouse would be one of the first people that your doctor would contact to make decisions for you.
- You have an even number of children who have different beliefs about the treatment you should get – under Virginia law, your children get equal power over your treatment decisions, which means that that their disagreement about your treatment could cause substantial family conflict and slow down treatment.
- You may not want some of the people on the state list to know about your injury or illness.
- You know that one of the people in that list has different beliefs about your treatment, and he/she may not want to authorize the treatment that he/she knows that you want.
Appointing an agent in your Advance Directive will ensure that the person you want making these important decisions about your care will be the person the doctors contact first.
An AD allows you to tell your physician and loved ones what treatment you want
In an Advance Directive, you can write down specific instructions or preferences about the health care you would like, and the health care you refuse. Without having those things written down, your doctor or loved ones may have a difficult time deciding what you would want during a time that you cannot make those decisions. Also, for example, your doctor or loved ones may not know about the side-effects that you have experienced on particular medication or about the bad experience you had at a particular treatment facility – by writing these things in your Advance Directive, you can help the people involved in your treatment to make the best decisions for you.
An AD may allow you to bypass the TDO/involuntary commitment process if you need to be hospitalized
In particular situations, an Advance Directive may be able to help someone get admitted to a psychiatric hospital without going through the Temporary Detention Order/involuntary commitment process. In Virginia, a person who is incapable of making informed decisions about their care can only be admitted to a psychiatric hospital for treatment through the TDO process unless he/she has authorized his/her agent in the Advance Directive to consent for him/her. Because the TDO/involuntary commitment process can be emotionally distressing, people may choose to have an AD to help them get admitted to a hospital without involving the court system.