OF CONSTITUTIONAL RIGHT
competent individual has a Constitutional right to determine the
kind of medical treatment he or she will receive. The individual
may also decide what type of treatment he or she will NOT receive.
These rights were confirmed by the United States Supreme Court in
case, which was decided in 1990.
Enacts the Patient Self-Determination Act
Self-Determination Act was enacted in 1991. The PSDA, a reaction
to the Cruzan case, is a modest step toward the goal of having our
Constitutional right of medical self-determination respected.
merely requires health care facilities to ask, when you are being
admitted, if you have an advance
NOT require the health care facility to prepare the document or
guide you in its preparation
NOT require the health care facility to look for your advance
NOT require the hospital or nursing home to keep your advance
directive in your medical chart
NOT describe a model advance directive that will be respected
in every state
Effective Is the Patient Self-Determination Act?
1995 Government Accounting Office study estimates that
of the adult population has completed an advance directive.
GAO study suggests that:
are not discussing with their patients the need for an advance
the advance directive in the course of hospital or nursing home
admission is ineffective because the newly-admitted patients are
usually very ill or upset. This is not a good time to discuss
advance directive issues.
physicians incorrectly believe that advance directives are only
for old people (Nancy Cruzan was about 25; Karen Quinlan was also
young). One author suggests that high school students be taught
about advance directives.