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The Department of Veterans Affairs (VA) published an interim final rule amending its regulation regarding informed consent and advance directives.  In that rulemaking, we amended the regulation by reorganizing it and amending language where necessary to enhance clarity; and made changes to facilitate the informed consent process, the ability to communicate with patients or surrogates through available modalities of communication, and the execution and witness requirements for a VA Advance Directive.  We make no changes to that interim final rule based on the one comment we received from the public.  However, we have determined that it is necessary to clarify roles and responsibilities of the practitioner and other members of the health care team pertaining to the informed consent process.  We now issue an interim final to address the role of trained health care professionals who are part of the patient’s health care team in the informed consent process as well as the practitioner’s personal responsibility to verify with the patient that the patient has been fully informed and voluntarily consents to the treatment or procedure.  We are providing the public an opportunity to comment on this new amendment.