Virginia is again considering legislation that, like Texas law, would empower hospitals to adjudicate disputes over life-sustaining medical treatment. At the end of December, Delegate Christopher Stolle introduced H.B. 226.If enacted, the law would add the following provision: "If, at the end of the 14-day period, the conflict remains unresolved despite compliance with the hospital's written policy . . . and the physician has been unable to identify another physician or facility willing to provide the care requested by the patient, the terms of the advance directive, or the decision of the agent or person authorized to make decisions . . . to which to transfer the patient despite reasonable efforts, the physician may cease to provide the treatment that the physician has determined to be medically or ethically inappropriate."
"However, artificial nutrition and hydration may be withdrawn or withheld only if, on the basis of physician's reasonable medical judgment, providing such artificial nutrition and hydration would (a) hasten the patient's death, (b) be harmful or medically ineffective in prolonging life, or (c) be contrary to the clearly documented wishes of the patient, the terms of the patient's advance directive, or the decision of an agent or person authorized to make decisions . . . regarding the withholding of artificial nutrition or hydration. In all cases, care directed toward the patient's pain and comfort shall be provided."
The law would also enact a new mandate for the state hospital licensing board: "Shall require that each hospital that is equipped to provide life-sustaining treatment shall develop a policy governing determination of the medical and ethical appropriateness of proposed medical care, which shall include (i) a process for obtaining a second opinion regarding the medical and ethical appropriateness of proposed medical care in cases in which a physician has determined proposed care to be medically or ethically inappropriate; (ii) provisions for review of the determination that proposed medical care is medically or ethically inappropriate by an interdisciplinary medical review committee and a determination by the interdisciplinary medical review committee regarding the medical and ethical appropriateness of the proposed health care; and (iii) requirements for a written explanation of the decision reached by the interdisciplinary medical review committee, which shall be included in the patient's medical record."
"Such policy shall ensure that the patient, his agent, or the person authorized to make medical decisions . . . (a) are informed of the patient's right to obtain his medical record and to obtain an independent medical opinion and (b) afforded reasonable opportunity to participate in the medical review committee meeting."
"Nothing in such policy shall prevent the patient, his agent, or the person authorized to make medical decisions . . . from obtaining legal counsel to represent the patient or from seeking other remedies available at law, provided that the patient, his agent, or the person authorized to make medical decisions . . . or legal counsel provides written notice to the chief executive officer of the hospital within 14 days of the date on which the physician's determination that proposed medical treatment is medically or ethically inappropriate is documented in the patient's medical record."
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