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National Center for Ethics in Health Care

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NCEHC identifies, analyzes and clarifies standards for practice through the development and interpretation of VHA national policies on ethics in health care.

VHA Handbook 1004.02: Advance Care Planning and Management of Advance Directives defines procedures for enabling health care staff to fulfill their obligation to support advance care planning for Veterans.

VHA Directive 1004.08: Disclosure of Adverse Events to Patients establishes the policy to ensure consistent practice in disclosing to patients or to the patient’s personal representative the occurrence of adverse events related to the patient’s clinical care.

VHA Handbook 1004.05: iMedConsent™ sets forth procedures related to the use of the iMedConsent™ software program.

VHA Handbook 1004.01: Informed Consent for Clinical Treatments and Procedures clarifies and updates VHA national policy on informed consent. It discusses the goals, scope, and key concepts related to patients’ informed consent for clinical treatments and procedures and the related responsibilities of VHA staff (see VHA Handbook 1200.5(1) and Handbook 1058.03 for VHA policy on informed consent for research.)

Informed Consent for Clinical Treatments and Procedures in VHA

Informed Consent: Medications with Boxed Warnings

VHA Directive 1005: Informed Consent for Long-Term Opioid Therapy for Pain establishes policy requiring patient education and signature informed consent for long-term opioid therapy for pain, and policy prohibiting the use of opioid pain care agreements (OPCA).

VHA Handbook 1004.03: Life-Sustaining Treatment (LST) Decisions: Eliciting, Documenting, and Honoring Patients’ Values, Goals, and Preferences standardizes Department of Veterans Affairs (VA) practices and terminology to promote a more personalized, proactive, patient-centered approach to decisions about LST. It establishes standardized procedures for eliciting, documenting, and honoring patients’ values, goals, and preferences regarding the initiation, limitation or discontinuation of LSTs.

LSTDI Webpage

VHA Directive 1004.04: State-Authorized Portable Orders (SAPO) defines policy for the use and execution of state-authorized portable do-not-attempt-resuscitation (DNAR/DNR) orders and SAPO for life-sustaining treatment by authorized Department of Veterans Affairs (VA) practitioners.