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Patient Self-Determination Act of 1991 (PSDA)

Notes: 1) Passed in 1990 largely as a result of the Missourd State Supreme Court ruling in the case of Nancy Cruzan, a woman in permanent coma after a motor-vehicle accident whose parents attempted to have life-sustaining treatment withdrawn. The court ruled that there must be clear & convincing evidence of a patient's wishes to withdraw care 2) requires hospitals, skilled nursing facilities, home health organizations & Health Maintenance Organizations to a) provide written information about each individual's rights to make decisions concerning their medical care & how the institution implements those rights b) document in the medical record whether or not the person has executed an advance directive c) ensure compliance with state law regarding respecting advance directives d) provide education for staff & community concerning advance directives 3) applies only to those health care organizations that participate in Medicare & Medicaid 4) studies suggest PSDA has done little to improve clinical care with regards to advance directives completion or end of life treatments patients receive

General

medical ethics

References

  1. Rosenfeld K. In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  2. Rosenfeld K. In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 25-28, 2002