Document Detail

The Patient Self-Determination Act and the future of advance directives.
MedLine Citation:
PMID:  1892335     Owner:  NLM     Status:  MEDLINE    
Living wills and other advance directives currently play a limited role in medical decision making. A new federal law, the Patient Self-Determination Act, will require health care providers in hospitals, nursing homes, and other facilities to inquire about the presence of advance directives, to record patient preferences in the medical record, and to develop institutional policies regarding the implementation of these directives. Unfortunately, the law does little to promote discussion or preparation of advance directives before hospitalization. Additional efforts to promote the use of advance directives can take place in the outpatient medical care system, in attorneys' offices, or through health insurers. Because most people have not yet prepared an advance directive, we suggest that institutions develop treatment policies for situations in which the wishes of patients who lack decisional capacity are not known. These policies should be designed to promote the patients' best interests, as defined by the consensus of the institutions' staff and members of the surrounding community.
P J Greco; K A Schulman; R Lavizzo-Mourey; J Hansen-Flaschen
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of internal medicine     Volume:  115     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1991 Oct 
Date Detail:
Created Date:  1991-10-17     Completed Date:  1991-10-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  639-43     Citation Subset:  AIM; E; IM    
Section of General Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104.
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MeSH Terms
Advance Directives / economics,  legislation & jurisprudence*
Costs and Cost Analysis
Cultural Diversity
Federal Government
Government Regulation
Patient Advocacy / legislation & jurisprudence*
Patient Participation / legislation & jurisprudence*
Risk Assessment
United States
Grant Support
Comment In:
Ann Intern Med. 1992 Feb 15;116(4):348; author reply 348-9   [PMID:  1733399 ]
Ann Intern Med. 1992 Feb 15;116(4):348; author reply 348-9   [PMID:  1733400 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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