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The Patient Self-Determination Act (PSDA) was passed by the U.S. Congress in 1990 as an amendment to the Omnibus Budget Reconciliation Act of 1990. It became effective on December 1, 1991. The legislation required many hospitals, nursing homes, home health agencies, hospice providers, 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 doctors.
The purpose of the Patient Self-Determination Act is to inform patients of their rights regarding decisions toward their own medical care, and ensure that these rights are communicated by the health care provider. Specifically, the rights ensured are those of the patient to dictate their future care (by means such as living will or power of attorney), should they become incapacitated. The PSDA requires information to be given to adult patients about their rights under state laws governing advance directives, including: 1) the right to participate in and direct their own healthcare decisions; 2) the right to accept or refuse medical or surgical treatment; 3) the right to prepare an advance directive; 4) information on the provider’s policies that govern the utilization of these rights. The act also prohibits institutions from discriminating against a patient who does not have an advance directive. The PSDA further requires institutions to document patient information and provide ongoing community education on advance directives.