Question

The Patient Self Determination Act PSDA (1991) allows for patients’ autonomy. Patients are able to refuse care. Should they be able to end their own lives? Why? Why not?

Answer 1

Ans) The Patient Self-Determination Act (PSDA) was passed by the United States 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, health maintenance organizations (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 physicians.

- Because the 1991 PSDA does not apply to individual physicians, private clinics and practices, most of which are incorporated for-profit organizations, the problem of cruel over treatment for profit of the elderly on Medicare/Medicaid was not controlled to the extent that Congress hoped would be possible when the states would implement the goals of the 1991 PSDA in state laws.

- The PSDA requires all health care agencies (hospitals, long-term care facilities, and home health agencies) receiving Medicare and Medicaid reimbursement to recognize the living will and power of attorney for health care as advance directives.

- The PSDA requires that hospitals and other specified types of health care organizations participating in Medicare and Medicaid programs inform patients of their right under existing State law to accept or refuse medical or surgical treatment and to formulate advance directives.