Advance directives: getting patients to complete them before they need them

We shook off the yoke of parentally based medicine more than a decade ago with the passage of the Patient Self-Determination Act (PSDA) of 1991. We were given the power to make decisions regarding the scope and intensity of the health care being provided to us. Yet many of our patients continue to cede responsibility to physicians and other health care providers by not completing the documents required to express their desires.