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Patient Self-Determination Act Cheat Sheet by

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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.

Common Terms

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.

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