• Physical injury – for example, if a person is in a coma after a car accident, or
  • Illness – for example,

The doctor must tell you of the decision and put it in your record.

and

When Will My Advance Directive Be Used?

  • if a mental health crisis affects someone’s thinking, or
  • if another type of disease (e.g., dementia) affects someone’s thinking, or
  • ​if a treatment has a side effect that affects thinking.

An AD is a back-up plan for a time when you cannot make health care decisions for yourself. 


People might not be able to make health care decisions because of:

The attending doctor must assess you in person and decide that you cannot make health care decisions for yourself,


A second doctor or a licensed clinical psychologist must assess you in person and independently decide that you cannot make health care decisions for yourself**,

*An individual cannot be found unable to make health care decisions just because the person has a diagnosed mental illness. (Va. Code §54.1-2982)


​**A second doctor or licensed clinical psychologist’s opinion is not needed if someone is in a coma.

How is the AD turned off if I don’t need it anymore?

Who decides that I cannot make health care decisions?

It takes two doctors to make that call and turn on your AD.* 


Specifically:

As soon as a doctor treating you finds that you can make health care decisions, your Advance Directive is turned off.