54.1-2972 - When person deemed medically and legally dead; determination of death; nurses' or physician assistants' authority to pronounce death under certain circumstances.
§ 54.1-2972. When person deemed medically and legally dead; determination ofdeath; nurses' or physician assistants' authority to pronounce death undercertain circumstances.
A. A person shall be medically and legally dead if:
1. In the opinion of a physician duly authorized to practice medicine in thisCommonwealth, based on the ordinary standards of medical practice, there isthe absence of spontaneous respiratory and spontaneous cardiac functions and,because of the disease or condition which directly or indirectly caused thesefunctions to cease, or because of the passage of time since these functionsceased, attempts at resuscitation would not, in the opinion of suchphysician, be successful in restoring spontaneous life-sustaining functions,and, in such event, death shall be deemed to have occurred at the time thesefunctions ceased; or
2. In the opinion of a physician, who shall be duly licensed and a specialistin the field of neurology, neurosurgery, electroencephalography, or criticalcare medicine, when based on the ordinary standards of medical practice,there is the absence of brain stem reflexes, spontaneous brain functions andspontaneous respiratory functions and, in the opinion of another physicianand such specialist, based on the ordinary standards of medical practice andconsidering the absence of brain stem reflexes, spontaneous brain functionsand spontaneous respiratory functions and the patient's medical record,further attempts at resuscitation or continued supportive maintenance wouldnot be successful in restoring such reflexes or spontaneous functions, and,in such event, death shall be deemed to have occurred at the time when theseconditions first coincide.
B. A registered nurse or a physician assistant who practices under thesupervision of a physician may pronounce death if the following criteria aresatisfied: (i) the nurse is employed by or the physician assistant works at(a) a home health organization as defined in § 32.1-162.7, or (b) a hospiceas defined in § 32.1-162.1, or (c) a hospital or nursing home as defined in §32.1-123, including state-operated hospitals for the purposes of thissection, or (d) the Department of Corrections; (ii) the nurse or physicianassistant is directly involved in the care of the patient; (iii) thepatient's death has occurred; (iv) the patient is under the care of aphysician when his death occurs; (v) the patient's death has beenanticipated; (vi) the physician is unable to be present within a reasonableperiod of time to determine death; and (vii) there is a valid Do NotResuscitate Order pursuant to § 54.1-2987.1 for the patient who has died. Thenurse or physician assistant shall inform the patient's attending andconsulting physicians of his death as soon as practicable.
The nurse or physician assistant shall have the authority to pronounce deathin accordance with such procedural regulations, if any, as may be promulgatedby the Board of Medicine; however, if the circumstances of the death are notanticipated or the death requires an investigation by a medical examiner, thenurse or physician assistant shall notify the chief medical examiner of thedeath and the body shall not be released to the funeral director.
This subsection shall not authorize a nurse or physician assistant todetermine the cause of death. Determination of cause of death shall continueto be the responsibility of the attending physician. Further, this subsectionshall not be construed to impose any obligation to carry out the functions ofthis subsection.
This subsection shall not relieve any registered nurse or physician assistantfrom any civil or criminal liability that might otherwise be incurred forfailure to follow statutes or Board of Nursing or Board of Medicineregulations.
C. Death, as defined in subdivision A 2, shall be determined by one of thetwo physicians and recorded in the patient's medical record and attested bythe other physician. One of the two physicians determining or attesting tobrain death may be the attending physician regardless of his specialty solong as at least one of the physicians is a specialist, as set out insubdivision A 2.
D. The alternative definitions of death provided in subdivisions A 1 and A 2may be utilized for all purposes in the Commonwealth, including the trial ofcivil and criminal cases.
(Code 1950, § 32-364.3:1; 1973, c. 252; 1979, c. 720, § 54-325.7; 1986, c.237; 1988, c. 765; 1996, c. 1028; 1997, cc. 107, 453; 2002, c. 92; 2004, c.92; 2010, c. 46.)