Essay Sample on Patient Self Determination Act

Published: 2023-01-28
Essay Sample on Patient Self Determination Act
Type of paper:  Essay
Categories:  Medicine Healthcare policy Nursing care Human services
Pages: 4
Wordcount: 956 words
8 min read


The quality of the healthcare service provided to individuals affects their quality of life. As such, healthcare systems and practitioners should always consider the need to adopt effective policies that would help alleviate pain and prolong the well-being of patients. The regulations put in place to govern health facilities and institutions also affect the quality of care provided to different people. Concisely, the United States government has had a tradition of ensuring that the rights of individuals are protected (Hoge, 1994). A recent policy that was implemented to enhance patient safety and protection of their rights is the Patient Self Determination Act (PSDA). Consequently, there will be the need to understand what PSDA entails, its history, and how it is utilized in healthcare like in the case of cancer patients and gerontology.

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The Patient Self Determination Act (PSDA)

PSDA encompasses a federal law that the U.S. Congress passed in 1990 to protect the right of a patient to self-determination as health care decisions are made and communicated. The Act requires healthcare institutions and organizations to provide information regarding advance directives on care to adult patients when they are admitted to a healthcare facility. However, the law is inapplicable to individual practitioners and physicians (Zwahr et al. 1997). Based on the Act, patients would be informed about their rights concerning own decisions on medical care that they might require. The healthcare providers communicate such rights to the patients. Through this, the patients will dictate the type of future care in situations where they may be incapacitated. The Patient Self Determination Act prevents the cruel treatment of the elderly and disabled patients by practitioners with the motive to gain profits. It also reduces Medicare costs, thereby saving money set for healthcare provision.

History of the PSDA

The Patient Self Determination Act was enforced in 1990. However, the legislation became effective in 1991, during which it applied to all healthcare institutions with exemptions of private clinics and individual practitioners. When the Act was implemented, it did not control the issue of cruel treatment of patients as they acquire healthcare services from health agencies, institutions, as well as organizations (Zwahr et al. 1997). However, in 2012, the cruel treatment issue was incorporated into the PSDA goals under the Act of False Claims. The U.S Health Department revealed that it would cooperate with the Justice Department on the prosecution of institutions that treat patients in non-compliance with the PSDA guidelines and requirements (Hoge, 1994).

How the PSDA Is Most Utilized In Healthcare

The Patient Self Determination Act is utilized across various departments in healthcare facilities and organizations. For instance, it is used in the department dealing with cancer patients and that of gerontology.

Cancer Patients

Most patients suffering from cancer may not be aware of advance directives and the right of protection of their rights of self-determination. The lack of awareness would cause excessive and aggressive care provision by providers in circumstances where the patients are unable to make decisions on the type of medical care. The PSDA can be utilized to help such patients in that it requires healthcare institutions to educate its personnel and the community on how advance directives are used (Hoge, 1994). Hospitals and other facilities may distribute relevant information to the public to equip them with adequate knowledge on the directives, as well as create awareness. The information can be disseminated in the form of pamphlets, by organizing public lectures, or even through the media.

Precisely, declining health may modify the decisions on health care that a patient makes. In this aspect, cancer patients can predict the decisions to make when diagnosed with the condition. The PSDA also enhances respect for the autonomy of cancer patients. In essence, through the advance directives stipulated in the Act, there would be ongoing communication between physicians and patients based on voluntary decision-making. Therefore, cancer patients will control their medical care autonomously as they anticipate future incapacity. Additionally, they have the right to choose or reject medical therapies that may be life-threatening.


When social workers and personnel in the nursing homes speak with residents on the issue of advance directives, the residents within such homes will properly understand their end-of-life decisions. In most cases, social workers use face-to-face communication to disseminate information regarding the directives (Zwahr et al. 1997). Some nursing homes may use written procedures to establish the capacity of residents to be informed about the directives. Nevertheless, voluntary nursing homes are more aggressive in the PSDA implementation due to the ethics committee as opposed to proprietary homes.

The residents of nursing homes may be faced with infirmities and progression of the disease as they stay in the facilities. As such, there is the need to provide them with advance directives, which would help inform their families and staff of the nursing facility about their preferences on end-of-life treatment. Equally important, the directives will provide some sense of legal protection for the nursing homes whenever ethically challenging decisions on treatment arise (Zwahr et al. 1997). However, failure to inform the residents about the advance directives when perceived to lack the capacity to make decisions would be problematic. This is because most nursing homes lack clear procedures that can be used to determine the cognitive capacity of the residents to execute a particular directive.


Hoge, S. K. (1994). The patient self-determination act and psychiatric care. Journal of the American Academy of Psychiatry and the Law Online, 22(4), 577-586. Retrieved from

Zwahr, M. D., Park, D. C., Eaton, T. A., & Larson, E. J. (1997). Implementation of the patient self-determination act: A comparison of nursing homes to hospitals. Journal of Applied Gerontology, 16(2), 190-207. Retrieved from

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