Patient Self-Determination Act: advocating for the patient's wishes

The United States has a long tradition of protecting an individual's rights. A recent example is the Patient Self-Determination Act (PSDA), federal law (1992, P.L. 101-508). It specifically allows competent individuals to communicate their preferences for life-sustaining medical treatment before they become incapacitated and are unable to make them known. It requires health care agencies, including home health agencies, receiving funds through Medicaid or Medicare programs to provide information and education about advance directives (ADs) to their patients, staff, and the community. Home health care agencies need to have protocols in place to be in compliance with the law. Agencies have to inform patients about their rights to make health care decisions and must maintain written policies about the implementation of those rights. The federal law prohibits home care providers from making the patient's care conditional on the existence of an AD or in any way altering the quality of care provided because of his or her wishes.