In short, the provision allows a health care consumer to relinquish, during a time when they are unable to make informed decisions, their right to refuse treatment.*  A one-page amendment version demonstrates the provision.

An important feature to point out to health care providers is that this provision, if selected by a person, requires attestation in writing by a physician or licensed clinical psychologist.  The physician or psychologist must check that the person understands the meaning of the provision, given its importance and complexity.

The physician or psychologist must attest that:​

  • The physician/psychologist is familiar with the person,
  • The person “is presently capable of making an informed decision,” and
  • The person understands the consequences of giving the agent this power.

*Note: § 54.1-2986.2(B)(2) makes clear that objections to withholding or withdrawal of life-prolonging treatments can never be overridden.

The Provision that Requires a Doctor’s Signature

When revisions were made to the HCDA in 2009/2010, Virginia added a provision that addresses treating someone over their objection (Va. Code § 54.1-2986.2).  This “protest provision” has been nicknamed the “Ulysses Clause” in the literature.