The DVA Advance Directive

Unlike the Department of Defense, the Department of Veterans Affairs (DVA) has not issued a regulation to make sure that all states accept your Advance Directive.  However, the DVA’s National Center for Ethics in Healthcare created a suggested Advance Directive form that attempts to meet the requirements of every state in the country.  You should check with your non-VA health care provider to confirm that this is true in your state.

When you have completed a state-based Advance Directive, DVA health care staff are required to make every effort to recognize that the form as valid and to follow the directives given in that form.  This requirement is based on Federal regulations (see 38 CFR § 17.32).

Advance Directives at VA facilities

The Department of Veterans’ Affairs (DVA) and the Veterans’ Health Administration (VHA) have taken steps to make sure that Advance Directive facilitation is available to veterans at all VA facilities.  VHA Handbook 1004.02, called “Advance Care Planning and Management of Advance Directives,” requires that:

  • Health care providers talk with patients about advance care planning
  • Health care providers help patients complete Advance Directives
  • Facility directors take specific steps to ensure that this is done

Getting Advance Directive help online 

The VHA has developed a website for veterans called My HealtheVet.  After creating a personal account on this website, veterans can go to the section titled “Your Life, Your Choices” to find exercises that help veterans make advance care planning decisions.

VHA’s Advance Directive policies 

The VHA Handbook makes the following key statements about advance care planning and about the role of VA staff in helping patients complete Advance Directives:

  1. “VA policy regarding advance care planning is consistent with the Department’s commitment to ensure that patients’ values, goals, and treatment preferences are respected and reflected in the care they receive.  VA is committed to creating a healthcare environment that promotes patient-centered care and shared decision making, an ongoing collaborative process between practitioners and patients or their surrogates, to which the practitioner contributes knowledge of medicine and the patient contributes values, preferences, and healthcare goals.  Practitioners who speak with their patients about their preferences are better equipped to faithfully interpret those​ preferences if, or when, the patient loses decision-making capacity.”

  2. “Patients and healthcare providers need encouragement, assistance, and resources for thinking and talking about patients’ preferences regarding future healthcare choices.  Patients need information and guidance to understand the implications of their preferences and to express​ them unambiguously.  For those who wish to complete an Advance Directive and for those who have already done so, policies and mechanisms are needed to ensure appropriate identification, documentation, and handling.  Thus, VHA staff has an important role in advance care planning.”   

Advance Directives and Veterans