Advance Directives

What kind of health care would you want if you were too ill or hurt to express your wishes? Advance directives are legal documents that allow you to convey your decisions about end-of-life care ahead of time. They provide a way for you to communicate your wishes to family, friends and health care professionals, and to avoid confusion later on.

A living will records your wishes about medical treatments, should you become unable to do so yourself. You can accept or refuse health care. There are many issues to address, including:

• The use of dialysis and breathing machines
• If you want to be resuscitated if breathing or heartbeat stops
• Tube feeding
• Organ or tissue donation

The agent for health care decisions is the document that names an individual to make medical decisions for you should you be unable to speak for yourself. Your agent should be someone you trust and who knows you well.

Copies of your advance directives are included in your health record for future use, should it become necessary. You are responsible for updating this information if you change your mind. We will honor the terms of your advance directives to the best of our ability. If we are not able to honor your request, we will make arrangements to transfer care to a provider or facility that can honor your wishes.

Resources for creating an advance directive

• Advance Care Planning guide from Honoring Choices Virginia
• Advance Directive form from Virginia Hospital and Health Care Association

For additional resources or help making a decision, please contact the Department of Pastoral Care (Chaplains’ Office) at (804) 828-0928 or the Department of Social Work at (804) 828-0212.

VCU Health complies with the following state requirements related to advance directives:

• An advance directive may authorize an agent to take any lawful actions necessary to carry out the patient’s wishes including but not limited to granting releases of medical liability to medical providers, releasing medical records, and making decisions regarding who may visit the patient.
• An advance directive may authorize an agent to admit a patient to a facility including a facility for the treatment of mental illness as permitted by law and the instructions of the patient. The patient may complete a Virginia Advance Directive for Mental Health Conditions form to provide further guidance to health care providers.
• An advance directive cannot authorize an agent to give permission for nontherapeutic sterilization, abortion or psychosurgery.
• An advance directive may authorize an agent to approve the patient’s participation in health care studies that increase scientific understanding, even if they offer no prospect of direct benefit to the patient, or in studies that offer direct therapeutic benefit to the patient.
• If the provisions of a patient’s advance directive conflicts with the authority conferred by emergency custody, temporary detention, involuntary admission and a mandated outpatient treatment order, the provisions of the patient’s advance directive that creates the conflict will have no effect. However, a patient’s advance directive will otherwise be in full effect.