Effective July 1, 2009 major changes will take effect with the Virginia Medical Advance Directive form.

Some of the changes are as follows:

1. Patients will be able to grant their surrogates the ability to admit them to inpatient hospitalization for the treatment of mental illness, over their objections, for a period of up to ten days, WITHOUT COURT AUTHORIZATION.

2. Judges will have the ability to grant the authority to surrogates to admit patients to inpatient hospitalization for treatment of mental illness, over the patient’s objectives, for a period of up to ten days, WITHOUT COURT AUTHORIZATION.

3. Patients will be able to grant their surrogates the power to consent to specific treatments over their objections WITHOUT COURT AUTHORIZATION.

4. The Ethics Committee will be able to authorize treatment over an incapacitated patient’s objections and with the consent of a surrogate, even if there is no advance directive, WITHOUT COURT AUTHORIZATION.

5. The advance directive form will become more complicated, with five sections rather than three, and although the overall witnessing requirements do not change, additional signatures will be necessary when the powers delineated above are included.

6. As a result of the new law, it becomes clearer than ever that a surrogate has the obligation to make decisions based on the expressed values of the patient, to the degree they can be known.  Furthermore, anyone who conceals, destroys or alters an advance directive or durable do not resuscitate order without the consent of the patient will be guilty of a class one misdemeanor.  If this action results in treatment that would not otherwise have been given, the tampering will be a class five felony.  If this action results in the withholding of care that would otherwise be granted, the tampering will be a class three felony.