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Virginia Revocación de Directiva Médica Anticipada

Revocación de Directiva Médica Anticipada - Virginia Revocation of Advance Medical Directive

State:

Virginia

Category:

Poder notarial - Atención médica - Revocaciones - Alaska

Control #:

VA-P021B

Format:

60 downloads

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Description

This is a revocation of the powers and authority granted in Form VA-P021 that expresses your right to communicate your desires regarding life-sustaining procedures and treatment, allows you to designate a health care agent to make these decisions and carry out your wishes and provides for anatomical gifts.

Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.

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Revocación de Directiva Médica Anticipada

STATUTORY REFERENCE

ALL REFERENCES ARE TO THE REVISED CODE OF VIRGINIA

REVOCATION OF ADVANCE DIRECTIVE

General Information (Â§54.1-2982):

As used in the Virginia Health Care Decisions Act, the following definitions are applicable:

"Advance directive" means a witnessed written document, voluntarily executed by the declarant in accordance with the requirements of Â§ 54.1-2983 or a witnessed oral statement, made by the declarant subsequent to the time he is diagnosed as suffering from a terminal condition and in accordance with the provisions of Â§ 54.1-2983.

"Agent" means an adult appointed by the declarant under an advance directive. The declarant may also appoint an adult to make, after the declarant's death, an anatomical gift of all or any part of his body.

"Incapable of making an informed decision" means the inability of an adult patient, who, because of mental illness, mental retardation, or any other mental or physical disorder which precludes communication or impairs judgment and who has been diagnosed and certified in writing by his attending physician and a second physician or licensed clinical psychologist after personal examination of such patient, to make an informed decision about providing, withholding or withdrawing a specific medical treatment or course of treatment because he is unable to understand the nature, extent or probable consequences of the proposed medical decision, or to make a rational evaluation of the risks and benefits of alternatives to that decision.

"Life prolonging procedure" means any medical procedure, treatment or intervention which utilizes mechanical or other artificial means to sustain, restore or supplant a spontaneous vital function, or is otherwise of such a nature as to afford a patient no reasonable expectation of recovery from a terminal condition and, when applied to a patient in a terminal condition, would serve only to prolong the dying process. The term includes artificially administered hydration and nutrition. Nothing shall prohibit the administration of medication or the performance of any medical procedure deemed necessary to provide comfort care or to alleviate pain, including the administration of pain relieving medications in excess of recommended dosages.

"Persistent vegetative state" means a condition caused by injury, disease or illness in which a patient has suffered a loss of consciousness, with no behavioral evidence of self-awareness or awareness of surroundings in a learned manner, other than reflex activity of muscles and nerves for low level conditioned response, and from which, to a reasonable degree of medical probability, there can be no recovery.

"Qualified patient" means a patient who has made an advance directive and either has been diagnosed and certified in writing by the attending physician and a second physician or licensed clinical psychologist after personal examination to be incapable of making an informed decision about providing, withholding or withdrawing a specific medical treatment or course of treatment or has been diagnosed and certified in writing by the attending physician to be afflicted with a terminal condition.

"Terminal condition" means a condition caused by injury, disease or illness from which, to a reasonable degree of medical probability a patient cannot recover and the patient's death is imminent or the patient is in a persistent vegetative state.

The Form (Â§ 54.1-2984):

An advance directive DOES NOT have to be in the form provided in the statute. It may

direct a specific procedure or treatment to be provided, such as artificially administered hydration and nutrition;

direct a specific procedure or treatment to be withheld; or

appoint an agent to make health care decisions for the declarant as specified in the advance directive if the declarant is determined to be incapable of making an informed decision.

If any other specific directions of an advance directive are ruled invalid, that does not affect the advance directive.

Revocation of Directive (Â§ 54.1-2985)

An advance directive may be revoked at any time by the declarant

by a signed, dated writing;

by physical cancellation or destruction of the advance directive by the declarant or another in his presence and at his direction; or

by oral expression of intent to revoke.

Any revocation is effective when communicated to the attending physician.

Note: All Information and Previews are subject to the Disclaimer located on the main forms page, and also linked at the bottom of all search results.

Revocación de Directiva Médica Anticipada

STATUTORY REFERENCE

ALL REFERENCES ARE TO THE REVISED CODE OF VIRGINIA

REVOCATION OF ADVANCE DIRECTIVE

General Information (Â§54.1-2982):

As used in the Virginia Health Care Decisions Act, the following definitions are applicable:

"Advance directive" means a witnessed written document, voluntarily executed by the declarant in accordance with the requirements of Â§ 54.1-2983 or a witnessed oral statement, made by the declarant subsequent to the time he is diagnosed as suffering from a terminal condition and in accordance with the provisions of Â§ 54.1-2983.

"Agent" means an adult appointed by the declarant under an advance directive. The declarant may also appoint an adult to make, after the declarant's death, an anatomical gift of all or any part of his body.

"Incapable of making an informed decision" means the inability of an adult patient, who, because of mental illness, mental retardation, or any other mental or physical disorder which precludes communication or impairs judgment and who has been diagnosed and certified in writing by his attending physician and a second physician or licensed clinical psychologist after personal examination of such patient, to make an informed decision about providing, withholding or withdrawing a specific medical treatment or course of treatment because he is unable to understand the nature, extent or probable consequences of the proposed medical decision, or to make a rational evaluation of the risks and benefits of alternatives to that decision.

"Life prolonging procedure" means any medical procedure, treatment or intervention which utilizes mechanical or other artificial means to sustain, restore or supplant a spontaneous vital function, or is otherwise of such a nature as to afford a patient no reasonable expectation of recovery from a terminal condition and, when applied to a patient in a terminal condition, would serve only to prolong the dying process. The term includes artificially administered hydration and nutrition. Nothing shall prohibit the administration of medication or the performance of any medical procedure deemed necessary to provide comfort care or to alleviate pain, including the administration of pain relieving medications in excess of recommended dosages.

"Persistent vegetative state" means a condition caused by injury, disease or illness in which a patient has suffered a loss of consciousness, with no behavioral evidence of self-awareness or awareness of surroundings in a learned manner, other than reflex activity of muscles and nerves for low level conditioned response, and from which, to a reasonable degree of medical probability, there can be no recovery.

"Qualified patient" means a patient who has made an advance directive and either has been diagnosed and certified in writing by the attending physician and a second physician or licensed clinical psychologist after personal examination to be incapable of making an informed decision about providing, withholding or withdrawing a specific medical treatment or course of treatment or has been diagnosed and certified in writing by the attending physician to be afflicted with a terminal condition.

"Terminal condition" means a condition caused by injury, disease or illness from which, to a reasonable degree of medical probability a patient cannot recover and the patient's death is imminent or the patient is in a persistent vegetative state.

The Form (Â§ 54.1-2984):

An advance directive DOES NOT have to be in the form provided in the statute. It may

direct a specific procedure or treatment to be provided, such as artificially administered hydration and nutrition;

direct a specific procedure or treatment to be withheld; or

appoint an agent to make health care decisions for the declarant as specified in the advance directive if the declarant is determined to be incapable of making an informed decision.

If any other specific directions of an advance directive are ruled invalid, that does not affect the advance directive.

Revocation of Directive (Â§ 54.1-2985)

An advance directive may be revoked at any time by the declarant

by a signed, dated writing;

by physical cancellation or destruction of the advance directive by the declarant or another in his presence and at his direction; or

by oral expression of intent to revoke.

Any revocation is effective when communicated to the attending physician.

Note: All Information and Previews are subject to the Disclaimer located on the main forms page, and also linked at the bottom of all search results.

Revocación de Directiva Médica Anticipada - Virginia Revocation of Advance Medical Directive

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Revocación de Directiva Médica Anticipada - Virginia Revocation of Advance Medical Directive

This form is part of a form package!

Description

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