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Tip of the week: Understand the Patient Self-Determination Act

Contemporary Long-Term Care Weekly, March 11, 2010

The Patient Self-Determination Act of 1990 is a critical piece of legislation that has had a profound effect on healthcare facilities. It allows patients, including residents in long-term care facilities, to play an active role in their care and treatment. Formerly, many patients’ wishes were subordinated by the physician or medical staff. The Patient Self-Determination Act provides patients with the power to direct their own care, be informed, and have their wishes honored regarding the care they will receive. This law does not state that the medical staff should honor a patient or resident’s wishes if they go against sound, prudent, and legally responsible care, leaving the medical staff and the facility liable for inappropriate practice.

However, it does empower the patient or resident to be an active participant, disallowing intervention that may not be authorized by the resident, family, or responsible party.

An important implication of this law has been a request by facilities for residents to provide some type of written healthcare directive upon admission. One of the most common documents is the living will, which spells out the types of medical intervention the resident may want, or not want, if he or she is unable to communicate with the medical staff. The durable power of attorney is another form of medical directive. Prior to reaching a medical crisis, patients or residents may assign an individual to advocate for their wishes and make their healthcare decisions should they no longer be able to do so on their own.

This is an excerpt from HCPro’s book, The Long-Term Care Administrator’s Field Guide, by Brian Garavaglia, PhD.

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