ULYSSES OR USELESS - Virginia's Revised Advance Medical Directive

In Greek mythology, Ulysses had himself tied to a ship's mast and ordered his crew not to release him until they had safely passed the Sirens - no matter how much he pleaded or protested. Effective July 1, 2009, Virginia's General Assembly amended Virginia Code to allow you to make a similar election in your Advance Medical Directive.

An Advance Medical Directive, sometimes known as a "Living Will", is a written document authorized by Virginia law in which a person can authorize an agent to make healthcare decisions and authorize treatment when that person is unable or incapable of making his or her wishes known. Until last year, however, the decisions were mainly limited to end of life issues, such as terminal illness, vegetative state, comas, and the treatment of those conditions. The 2009 changes allowed a broader range of choices.

The "Ulysses" provision allows you, if competent at the time you execute an Advance Medical Directive (as attested to by two physicians and/or licensed clinical psychologists) to authorize, in advance, your admission to a healthcare facility for treatment of mental illness or the specific types of healthcare identified in the Advance Medical Directive - even if you protest at that later time.

The purpose, of this change and other changes effective as of July 1, 2009, was and is to give Virginia residents more choices in directing their healthcare. Many of these changes are found useful by our clients - involving healthcare decisions that are not necessarily related to end of life, as well as dealing with organ and body donation. These choices require careful thought - in part because there are more decisions to make, but also because the revised format allows a person to fill in blanks as to their medical choices (and not simply choose from a general checklist). This is somewhat daunting because no one knows every type of treatment available now - or what will be available with medical advances during the life of this document, but by adding and deleting, our clients can truly craft an Advance Medical Directive that represents their choices for healthcare that their agents will implement.

We have yet to have a client choose the "Ulysses" provision, in large part because they do not want to give up the ability to protest treatment options - in effect to give up choice later by making a choice now. The General Assembly enacted these amendments to provide a person more choices in directing their own healthcare. Time will tell whether this election will be widely accepted or will prove to be a choice that is ignored.

Advance Medical Directives are one of the general estate planning documents needed by a majority of our clients. Other documents include a Will and a General Durable Power of Attorney. If you have Will or estate planning document questions, please contact Dennis Cate at Compton & Duling, L.C. (703) 565-5121 or DCate@ComptonDuling.com