Patient Self-Determination Act

The Patient Self-Determination Act (PSDA) was passed by the U.S. Congress in 1990 as an amendment to the Omnibus Budget Reconciliation Act of 1990. Effective on December 1, 1991, this legislation required many hospitals, Nursing Homes, home health agencies, hospice providers, HMOs, and other health care institutions to provide information about advance health care directives to adult patients upon their admission to the healthcare facility. This law does not apply to individual doctors. Section 1233 of the proposed HR 3200 would have authorized reimbursements for physician counseling regarding advance directives (once every five years) but it was not included in the 2010 Affordable Care Act because of uproar over supposed "death panels".

Requirements

The requirements of the PSDA are as follows:

• Patients are given written notice upon admission to the health care facility of their decision-making rights, and policies regarding advance health care directives in their state and in the institution to which they have been admitted. Patient rights include:

1. The right to facilitate their own health care decisions
2. The right to accept or refuse medical treatment
3. The right to make an advance health care directive

• Facilities must inquire as to the whether the patient already has an advance health care directive, and make note of this in their medical records.
• Facilities must provide education to their staff and affiliates about advance health care directives.
• Health care providers are not allowed to discriminately admit or treat patients based on whether or not they have an advance health care directive.

Purpose

The purpose of the Patient Self-Determination Act was to inform patients of their rights regarding decisions toward their own medical care, and ensure that these rights are communicated by the health care provider. Specifically, the rights ensured are those of the patient to dictate their future care (by means such as living will or power of attorney), should they become incapacitated.

Further reading

• Yates JL, Glick HR (1997). "The failed Patient Self-Determination Act and policy alternatives for the right to die". J Aging Soc Policy 9 (4): 29–50. PMID 10186890. 
• Leahman D (2004). "Why the Patient Self-Determination Act has failed". N C Med J 65 (4): 249–51. PMID 15481498. 

External links

• American Cancer Society article
• THE REQUIREMENTS OF THE PATIENT SELF-DETERMINATION by Lawrence P. Ulrich, Ph.D.
• Kring DL (2007). "The Patient Self-determination Act: has it reached the end of its life?". JONAS Healthc Law Ethics Regul 9 (4): 125–31, quiz 132–3. doi:10.1097/01.NHL.0000300767.91800.17. PMID 18043329. http://www.nursingcenter.com/library/journalarticle.asp?article_id=755746. 
• Walerius T, Hill PD, Anderson MA (2009). "Nurses' knowledge of Advance Directives, Patient Self-determination Act, and Illinois Advance Directive Law". Clin Nurse Spec 23 (6): 316–20. doi:10.1097/NUR.0b013e3181be3273. PMID 19858904. http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=940924.