In 1991, The Patient Self-Determination Act (PSDA) was enacted, and enabled people to exercise their right to make decisions about the type and extent of health care they choose to accept or deny when under medical supervision. This applies to care provided in a variety of medical environments including, hospitals, nursing facilities, long-term health institutes and home health agencies that receive Medicare and Medicaid reimbursement. Virginia law recognizes a patient’s right to consent to treatment, and their right to refuse medical treatment. Advance directives and DNR orders are two important components to a patient’s right to make decisions on receiving and denying treatment. An advance directive permits a person to make decisions and state preferences regarding medical care. It also provides options in the event a person is unable to make these decisions themselves, including the ability to appoint a competent adult to act as a decision maker on their behalf. A durable do-not-resuscitate order (DNR) is a medical order written by a doctor with the patient’s consent. It instructs health care providers to withhold cardiopulmonary resuscitation (CPR) if breathing stops or if the heart stops beating. DNR orders are to be followed by emergency medical services (EMS) or any other licensed health care provider. It is valid until revoked by the ordering doctor.