The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices. According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient. Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates.

Provides information on the Patient Self-Determination Act (PSDA) implementation & the effectiveness of advance directives in ensuring patient self-determination. Focuses on the extent to which institutional health care providers & the federal government are complying with the provisions of the act & how the public uses advance directives to express their end-of -life treatment wishes. Analyzes how an advance directive effects a patient's desired care.

Congress passed the Patient Self-Determination Act in 1990 to reinforce individuals' constitutional right to decide their final health care. The act requires health care providers to increase public awareness about the use of "advance directives"--A living will or health care power of attorney. An advance directive spells out how life-support decisions should be carried out should the patient become terminally ill and unable to communicate his or her wishes. This report provides information on the act's implementation and on the effectiveness of advance directives in ensuring patient self-determination. GAO looks at the extent to which (1) institutional health care providers and the federal government are complying with the act's provision, (2) the public uses advance directives to express their end-of-life treatment wishes, and (3) an advance directive affects a patient's desired care.

Patient Self-Determination Act: Providers Offer Information on Advance Directives but Effectiveness Uncertain