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Patient Self
Determination Act 1990
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An important patient right
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Congress passed the Patient
Self Determination Act (PSDA) in 1990. The regulations were
implemented in December 1991. This piece of legislation gives
patients the right to make choices and decisions about the types and
extent of medical care they wish for themselves. With this
act, patients can specify if they want to accept or refuse
specific medical care. They can also identify a legal
representative for urgent healthcare decision purposes. Then
if they become unable to make decisions due to illness, the
patients' wishes have been clearly documented at an earlier point of
time. This act further defines rights of self-determination
which are guaranteed in the Fourteenth Amendment. If a patient
establishes a living will or durable power of attorney for
healthcare purposes, the patient is acting on his/her rights of self
determination. |
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Patient involvement in
healthcare decision making
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With passage of PSDA, all
hospitals, long term care facilities, home health agencies, hospice
programs and HMOs that receive Medicare and Medicaid dollars must
recognize a patient's living will and power of attorney for
healthcare as advance directives. Healthcare organizations
must take the four following actions to assure compliance with these
federal regulations:
- Must ask each patient at time of
admission if he/she has an advance directive
- Must give the patient written information
about establishing an advance directive (specifically, the
patient's rights under law)
- Must document if the patient has an
advance directive that is placed in the patient's medical record
- Must be able to demonstrate policies and
procedures that meet the requirements of the federal and state
laws concerning advance directive
Patients are then able to decide in advance
what medical treatment they want to receive if they become
physically or mentally unable to communicate their wishes. |
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Big issues in compliance
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Major issues in compliance deal
with the following:
- Where does the patient place his/her
advance directive so it is readily available when needed?
Experts state this document should definitely NOT be in the safety
deposit box. Many suggest the person place it in a moisture
proof container inside the refrigerator (which is a fire safe
site). It is important to place a notice near the front door
of the home showing where the document is located.
- Does the patient leave the original
advance directive (living will and power of attorney) with
hospital medical records? Experts recommend that the patient
keep possession of the original document and give healthcare
providers a copy for their medical records.
- Can the patient feel assured that once
he/she notifies a healthcare provider (particularly hospital) of
advance directives, it is no longer necessary to inform the
provider during follow-up visits and admissions? Experts
strongly suggest it is important to append medical records with
advance directives at every occasion of admission, particularly to
a hospital or long term care facility.
Are you now a better educated consumer?
Spread the word. |
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