title: Patient Self-Determination Act.
abstract: The Patient Self-Determination Act (PSDA) took effect December 1, 1991. As a direct result of the Nancy Cruzan case, this Act is intended to promote awareness and discussion of health-care issues in preparation for medical decisions at the end of life. The mechanism is the federal requirement that any health-care institution which expects to receive Medicare or Medicaid funds must inform patients upon admission of state laws governing self-determination issues. Any discussion among patients, families and their physicians stimulated by the PSDA is healthy. Physicians must be prepared for new questioning by patients about self-determination issues and must be knowledgeable of state laws. They must also defend against bureaucratization of medical decision-making by taking a leadership role in the patient autonomy movement, injecting into the movement an awareness of the rational capacity of medical technology.
authors.affiliation: Department of Internal Medicine, University of Florida Health Science Center, Jacksonville.
authors.forename: K A
authors.initials: KA
authors.lastname: Koch
mesh_terms: D016223:Advance Directives / Q000331:legislation & jurisprudence; D006801:Humans; D016224:Living Wills / Q000331:legislation & jurisprudence; D010344:Patient Advocacy / Q000331:legislation & jurisprudence*; D010358:Patient Participation / Q000331:legislation & jurisprudence*; D010817:Physician-Patient Relations; D014481:United States