Patient Self-Determination Act
Most hospitals, nursing homes, home health agencies, and HMO's routinely provide information on advance directives at the time of admission. They are required to do so under a federal law called the Patient Self-Determination Act (PSDA).
The PSDA simply requires that most health care institutions (but not individual doctors) do the following:
1. Give you at the time of admission a written summary of: your health care decision-making rights, the facility's policies with respect to recognizing advance directives. Note: Each state has developed such a summary for hospitals, nursing homes, and home health agencies to use
2. Ask you if you have an advance directive, and document that fact in your medical record. It is up to you to make sure they get a copy of it.
3. Educate their staff and community about advance directives.
4. Never discriminate against patients based on whether or not they have an advance directive. Thus, it is against the law for them to require either that you have or not have an advance directive.
1. ADVANCE DIRECTIVE - a written statement of instruction completed by a competent person and recognized by state law stating provision of health care desired in the event of incapacity. This would include Living Wills, Health Care Proxy, DNR, and Durable Power of Attorney.
2. INFORMED CONSENT - a legal term referring to the right to make medical treatment decisions. This includes the right to be informed of one's medical condition and prognosis, the risks and benefits associated with a recommended procedure or course of treatment, and what alternatives exist. In the case of mental incapacity, an individual's right to give or withhold informed consent typically passes to the person's legal representative; an agent or attorney-in-fact under a durable power of attorney, a court appointed guardian, or a close family member.
3. DURABLE POWER OF ATTORNEY FOR HEALTH CARE - this is a lawyer, appointed by you when you (the resident) are capable of making decisions, who will represent your medical wishes and directives when you are competent, and continue with those same wishes and
directives when you are no longer competent.
4. HEALTH CARE PROXY - a document which delegates authority to another individual (known as a Health Care Agent) to make health care decisions on behalf of the individual when that individual is incapacitated.
5. HEALTH CARE AGENT - an adult to whom authority to make health care decisions is delegated under a health care proxy.
6. LIVING WILL - a document which contains specific instructions concerning an individual's wishes about the type of health care choices and treatments that an individual does or does not want to receive, but which does not designate an agent to make health care decisions.
Patient Self-Determination Act
Common Terms (continued)
7. CLOSE FRIEND - any person, 18 years of age or older, who presents an affidavit to an attending physician stating that he or she is a close friend of the patient and that he or she has maintained such regular contact with the patient as to be familiar with the patient's activities, health and religious or moral beliefs and stating the facts and circumstances that demonstrate
such familiarity. (Close friends may consent to DO NOT RESUSCITATE (DNR) orders in the absence of an agent or other surrogate).
8. DO NOT RESUSCITATE (DNR) ORDERS - an order by the physician not to attempt cardiopulmonary resuscitation in the event a patient suffers cardiac or respiratory arrest.
9. SURROGATE - (FOR DO NOT RESUSCITATE ONLY) the person selected to make a decision regarding resuscitation on behalf of another person.
10. CAPACITY - the ability to understand and appreciate the nature and consequences of health care decisions, including the benefits and risks of the alternatives to any proposed health care, and to reach an informed decision.
11. TERMINAL CONDITION - an illness or injury from which there is no recovery, and which reasonably can be expected to cause death within one year.
12. PERSISTENT VEGETATIVE STATE - a type of irreversible coma caused by severe brain damage where a person has reflexes but no apparent ability to think or respond.