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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. After a review of the public comments, we are making an amendment to the interim final rule and providing the public an opportunity to comment on this new amendment.