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Advance Medical Directives in U.S. Hospitals and Nursing Homes: The Implementation and Impact of the Patient Self-Determination Act

Published online by Cambridge University Press:  17 May 2016

Henry R. Glick ,
Marie E. Cowart  and
J. Donald Smith
Henry R. Glick
Affiliation:
Florida State University, USA
Marie E. Cowart
Affiliation:
Florida State University, USA
J. Donald Smith
Affiliation:
Florida State University, USA
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Abstract

In 1990, the U.S. Supreme Court endorsed living wills and other written advance medical directives as the best way for people to indicate their desires regarding end-of-life medical treatment. Congress then enacted the Patient Self-Determination Act (PSDA), which requires most medical facilities to provide information about advance medical directives. However, results from a national survey of hospital and nursing home administrators reveal that the law is having little practical effect on patients and residents. Medical institutions need to institutionalize a more positive approach to advance directives, but other right-to-die policies are also needed.

Type
Patient Self-Determination
Information
Politics and the Life Sciences , Volume 14 , Issue 1 , February 1995 , pp. 47 - 59
Copyright
Copyright © Association for Politics and the Life Sciences 

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References

Bardach, E. (1977). The Implementation Game. Cambridge, MA: M.I.T. Press.Google Scholar
Blechner, B., Wetle, T., Dubitsky, D., Fuller, D., and Walker, L. (1992). “Anticipated and Actual Problems with OBRA Regulations on Advance Directives and Physical Restraints in Nursing Homes.” Presented at the annual meeting of the Gerontological Society of America, Washington, DC.Google Scholar
Bond, J.R. and Johnson, C.A. (1982). “Implementing a Permissive Policy: Hospital Abortion Services after Roe v. Wade.” American Journal of Political Science 44:1–24.CrossRefGoogle Scholar
Cameron, K.A. and Glick, L.S. (1993). “The Patient Self-Determination Act of 1990.” Yale University. Typescript.Google Scholar
Capron, A. (1990). “The Patient Self-Determination Act: Not Now.” Hastings Center Report 20(5):35–36.CrossRefGoogle Scholar
Choice in Dying (1991). Choice in Dying News (Fall-Winter).Google Scholar
Congressional Record (1989). 101st Cong., 1st sess. Vol. 135, no. 140.Google Scholar
Congressional Record (1990a). 101st Cong., 2nd sess. Vol. 136, no. 39.Google Scholar
Congressional Record (1990b). 101st Cong., 2nd sess. Vol. 136, no. 85.Google Scholar
Cruzan v. Director, Missouri Department of Health (1990). 110 U.S. 2841.Google Scholar
Emanuel, E., Weisberg, D., Gonin, R., Hummel, L. and Emanuel, L. (1993). “How Well Is the Patient Self-Determination Act Working?” American Journal of Medicine 95:619–28.CrossRefGoogle Scholar
Fletcher, J.C. (1990). “The Patient Self-Determination Act: Yes.” Hastings Center Report 20(5):33–35.CrossRefGoogle Scholar
Glick, H.R. (1992). The Right to Die. New York: Columbia University Press.CrossRefGoogle ScholarPubMed
Glick, H.R. (1994). “The Impact of Permissive Policies: The U.S. Supreme Court and the Right to Die.” Political Research Quarterly 47(1):207–22.Google Scholar
Glick, H.R., Cowart, M.E., and Smith, J.D.(in press). “The Implementation and Impact of the Patient Self-Determination Act.” Journal of Applied Gerontology.Google Scholar
Goldstein, M.K., Vallone, R.P., Pascoe, D.C., and Winograd, C.H. (1991). “Durable Power of Attorney for Health Care: Are We Ready for It?” Western Journal of Medicine 155:263–68.Google Scholar
Goggin, M.L., Bowman, A.O.M., Lester, J.P., and O'Toole, L.J. Jr. (1990). Implementation Theory and Practice: Toward a Third Generation. Glenview, IL: Scott, Foresman/Little, Brown Higher Education.Google Scholar
Greco, P.J., Schulman, K.A., Lavizzo-Mourey, R., and Hansen-Flaschen, J. (1991). “The Patient Self-Determination Act and the Future of Advance Directives.” Annals of Internal Medicine 115:639–43.CrossRefGoogle Scholar
Health Care Financing Administration, Health Standards and Quality Bureau, Office of Survey and Certification (1993). Hospitals and Nursing Homes in the United States. Bethesda, MD.Google Scholar
Hudson, T. (1991). “Hospitals Work to Provide Advance Directives Information.” Hospitals 65(3):26, 28, 30–32.Google Scholar
Johnson, C.A. and Canon, B.C. (1984). Judicial Policies: Implementation and Impact. Washington, DC: Congressional Quarterly Press.Google Scholar
Lynn, J. and Teno, J.M. (1993). “After the Patient Self-Determination Act.” Hastings Center Report 23(1):20–24.CrossRefGoogle Scholar
Mazmanian, D.A. and Sabatier, P.A. (1983). Implementation and Public Policy. Glenview, IL: Scott, Foresman.Google Scholar
McCloskey, E.L. (1991). “The Spirit of the PSDA.” Hastings Center Report 21(5):S14–S15.CrossRefGoogle Scholar
Mezey, M. (1991). “Community Education.” Hastings Center Report 21(5):S11–S12.CrossRefGoogle ScholarPubMed
Mezey, M. and Latimer, B. (1993). “The Patient Self-Determination Act.” Hastings Center Report 23(1):16–20.CrossRefGoogle Scholar
Obade, C.C. (1990). “The Patient Self-Determination Act: Right Church, Wrong Pew.” The Journal of Clinical Ethics 1:320–22.CrossRefGoogle Scholar
Omnibus Budget Reconciliation Act of 1990 (1990). Pub. L. No. 101–508 §§4206, 4751 (codified in scattered sections 42 U.S.C., especially §§1395cc, 1396a [West Supp. 1991]).Google Scholar
Pachmayer, J. (1992). “The Implications of Advance Directives on the Health Care Institution.” Hospital and Health Services Administration 37:560–64.Google Scholar
Patient Self-Determination Act—PSDA (1990). SeeOmnibus Budget Reconciliation Act of 1990.Google Scholar
Pressman, J.L. and Wildavsky, A. (1984). Implementation. Third edition. Berkeley, CA: University of California Press.Google Scholar
Roe, J.M., Goldstein, M.K., Massey, K., and Pascoe, D. (1992). “Durable Power of Attorney for Health Care: A Survey of Senior Center Participants.” Archives of Internal Medicine 152:292–96.CrossRefGoogle Scholar
Solomon, M.Z., O'Donnell, L., Jennings, B., Guifoy, V., Wolf, S.M., Nolan, K., Jackson, R., Koch-Weiser, D., and Donnelley, S. (1993). “Decisions Near the End of Life: Professional Views on Life-Sustaining Treatments.” American Journal of Public Health 83:14–22.CrossRefGoogle Scholar
Stelter, K.L., Elliott, B.A., and Bruno, C.A. (1992). “Living Will Completion in Older Adults.” Archives of Internal Medicine 1152:954–59.Google Scholar
Teno, J.M., Sabatino, C., Parisier, L., Rouse, F., and Lynn, J. (1993). “The Impact of the Patient Self-Determination Act's Requirement that States Describe Law Concerning Patients' Rights.” Journal of Law, Medicine and Ethics 21:102–8.CrossRefGoogle Scholar
Van Horn, C.E. and Van Meter, D.S. (1976). “The Implementation of Intergovernmental Policy.” In Jones, C.O. and Thomas, R.D., (eds.), Public Policy Making in a Federal System. Beverly Hills, CA: Sage.Google Scholar
Walker, R., Schonwetter, R., Sangster, E., and Robinson, B. (1992). “Physicians' Perceptions of Advance Directives.” Presented at the annual meeting of the American Gerontological Society of America, Washington, DC.Google Scholar
White, M.L. and Fletcher, J.C. (1991). “The Patient Self-Determination Act: On Balance, More Help than Hindrance.” New England Journal of Medicine 266:410–12.Google Scholar
Wolf, S.M. et al. (1991). “Sources of Concern about the Patient Self-Determination Act.” The New England Journal of Medicine 325:1666–71.CrossRefGoogle Scholar