The Patient Self Determination Act (PSDA), 42 U.S.C. §§ 1395cc(f)(1), 1396a(w)(1), and its implementing regulations require medical facilities (hospitals, nursing homes and home-nursing programs) to provide written information to patients about their rights under state law, including the right to accept or refuse treatment and to give advance directives. ( See a sample summary as it applies to one state’s law. The provider must also document advance directives in each patient’s record, educate the staff and patients about advance directives and not discriminate in care for or against patients with advance directives. The statute requires every facility to have and to communicate a policy about implementing advance directives.
If advance directives are violated, these required policies may be useful to show that the hospital should have made caregivers aware of advance directives. A 1998 study (Archives of Family Medicine, Vol.7, No.5) found that the number of nursing home patients who had executed advance directives had increased significantly since passage of PSDA, but that the materials provided under the act had far less impact than individual experience with the death of a family member or friend.