A History of "End-of-Life" Initiatives in West Virginia

1984 The WV Legislature enacts the "Natural Death Act." Any person 18 or older may execute a "Declaration" directing the withholding or withdrawal of life sustaining procedures. (SB 62, passed March 6, 1984. § 16-30-1 to 10)

1984 The WV Legislature enacts the "Hospice Licensure Act," which established guidelines for the treatment of the terminally ill and licensure of hospice facilities. (SB 679, passed March 10, 1984. §16-5I-1 to 6)

1990 The WV Legislature enacts the "Medical Power of Attorney Act." Any person 18 or older may designate a representative to give, withhold or withdraw consent for medical procedures in the event that they become incapacitated. (HB 4197, passed March 1, 1990. §16-30A-1 to 20)

1991 The WV Legislature amends the "Natural Death Act" by updating the term "Declaration" to a "Living Will." Terminology is updated and a provision that a living will executed in another state, as long as it conforms to WV law, is to be recognized as valid. (SB 416, passed March 9, 1991. § 16-30-1 to 13)

1993 The WV Legislature enacts the "Health Care Surrogate Act," which established procedures for the selection of a surrogate decision maker by a health care provider in instances where the patient is incapacitated, and no representative has been previously authorized or is available. (HB 2599, passed April 8, 1993. § 16-30B-1 to 16)

1993 The WV Legislature enacts the "Do Not Resuscitate Act," which created a "Do Not Resuscitate Form" for persons who do not wish to have cardiopulmonary resuscitation. The form is be signed by a physician and may be issued through the authorization of a surrogate decision maker. For persons not residing in a health care facility the order may be issued by means of a card or necklace to be carried by the patient. (HB 2616, passed April 8, 1993. § 16-30C-1 to 16)

1994 The WV Legislature enacts the "WV Guardianship and Conservatorship Act." Removes the obligation of a circuit court to appoint the county sheriff as the "guardian of last resort." This act clarified that persons having an advance directive or a surrogate decision maker are exempt. (HB 4508, passed March 12, 1994. §44A-1,2,3)

1998 The WV Legislature enacts the "Management of Intractable Pain," which provided that no physician may be subject to sanctions or disciplinary procedures for prescribing pain-relieving substances for controlling intractable pain as long as they are operating within their scope of practice. (HB 4058, passed April 8, 1998. § 16-30A-1 to 4)

2000 The WV Legislature enacts the "Health Care Decisions Act." This replaces and combines the "Natural Death Act," "Medical Power of Attorney Act" and the "Health Care Surrogate Act." The provisions of the previous legislation remain intact with some language modernization. The addition of a process for resolving conflicting advanced directives or between a surrogate and a physician is described and in certain instances a single physician can make the determination of incapacity. (HB 4144, passed April 4, 1990. § 16-4B-1, 16-30C-5 and 16-4E-1 et seq.)

2000 The Joint Policy Statement on Pain Management at the End-of-Life is issued by the WV Initiative to Improve End-of-Life Care. A statement was developed and issued to show the combined support of West Virginia's professional medical boards on the necessity of adequate pain control for patients with terminal illness. The statement was intended to alleviate health care professional uncertainty and to ensure better pain management.

2001 The WV Legislature amends the general provisions for licensing boards to include a requirement that licensed medical professionals include two hours of study on end-of-life care, including pain management, during each continuing education reporting period. (HB 2815, passed April 27, 2001. § 30-1-7a)

2002 The WV Legislature amends the Management of Intractable Pain to include policy or position statements under the definition of an accepted guideline for pain management and provides that a physician practicing within an accepted guideline not be subject to sanctions or criminal punishment. (HB 4275, passed March 18, 2002. § 30-3A-1,2)

2002 The WV Legislature amends the Health Care Decision Act to include the use of the POST (Physician Orders For Scope of Treatment) form, which reflects the wishes of a patient as to advanced medical directives. Immunity to a health care provider or facility that relies upon orders in a POST form is included, along with provisions regarding the use of the POST form in inter-institutional transfers. This legislation also prohibits a person holding a medical power of attorney from cancelling an already paid for funeral contract in order to obtain a refund of the purchase price. (SB 658/HB 4238, passed as SB 658 on April 3, 2002. § 16-30-3 to 25 and 16-30C-3 to 13)

2002 On July 1, 2002, the West Virginia Center for End-of-Life Care was officially established through support from the West Virginia Legislature. The new center evolved from the West Virginia Initiative for End-of-Life Care and will continue efforts to improve all aspects of end-of-life care for West Virginians. The West Virginia Center for End-of-Life Care will serve as an educational and resource center for health care professionals, the public, and legislators seeking information and training about end-of-life care in West Virginia.

2012 The WV Center for End-of-Life Care (Center) and the WV Health Information Network (WVHIN) launched the WV e-Directive Registry.   The Registry makes advance directives and medical orders available online 24/7 to those providing patient care, allowing patients’ wishes and medical orders to be respected throughout the continuum of health care settings.