If you live in Virginia and have an advance medical directive, it may not fully address your end-of-life wishes. A typical advance medical directive outlines whether you want life-prolonging treatment if your death is imminent due to a terminal illness, or you are in a persistent vegetative state.
Among the array of life-prolonging measures often listed is artificially administered nutrition and hydration delivered through a tube placed in the gastrointestinal tract or via a catheter.
What is likely not mentioned in your directive is whether you want food and fluids administered by hand if you are in the advanced stages of dementia and unable to feed yourself.
This lack of inclusion is not necessarily an oversight. Allowing dying patients to control decisions about their own medical care has been a controversial uphill battle, resulting in directives that are limited in scope.
Advance medical directives are a relatively new concept, with the earliest proposed state legislation approving their use appearing in Florida in 1968. California passed the first law adopting the use of advance directives eight years later, after several similar bills had been defeated.