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

Omnibus Budget Reconciliation Act of 1990

The Omnibus Budget Reconciliation Act of 1990 is a United States statute enacted pursuant to the budget reconciliation process to reduce the United States federal budget deficit....

. Effective on December 1, 1991, this legislation required many hospital

Hospital

A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....

s, Nursing Home

Nursing home

A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...

s, home health agencies

Home care

Home Care, , is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as domiciliary care or social care), is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as...

, hospice providers

Hospice

Hospice is a type of care and a philosophy of care which focuses on the palliation of a terminally ill patient's symptoms.In the United States and Canada:*Gentiva Health Services, national provider of hospice and home health services...

, HMOs

Health maintenance organization

A health maintenance organization is an organization that provides managed care for health insurance contracts in the United States as a liaison with health care providers...

, 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 panel

Death panel

"Death panel", , is a term that originated during a 2009 political debate regarding health care reform in the United States. The death panel claim portrayed the health care bills then pending before the U.S. Congress as encouraging euthanasia for the elderly and as rationing health care for the...

s".

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

Living will

An advance health care directive, also known as living will, personal directive, advance directive, or advance decision, are instructions given by individuals specifying what actions should be taken for their health in the event that they are no longer able to make decisions due to illness or...

 or power of attorney

Power of attorney

A power of attorney or letter of attorney is a written authorization to represent or act on another's behalf in private affairs, business, or some other legal matter...

), should they become incapacitated.

External links

• American Cancer Society article
• THE REQUIREMENTS OF THE PATIENT SELF-DETERMINATION by Lawrence P. Ulrich, Ph.D.