Abstract
On December 1, 1991, the requirements of a new federal law, the Patient Self-determination Act (PSDA), went into effect.1 The PSDA requires hospitals, nursing home facilities, hospices, home health care programs, and health maintenance organizations to give adults (in most states, individuals 18 years of age or older) information about their rights under the laws of their state to accept or refuse medical treatment; to prepare an advance directive such as a living will which states the individual's preferences for medical treatment under certain circumstances that might occur in the future, at a time when the patient is no longer able to make decisions; and to appoint a health care agent or proxy, someone to make health care decisions on behalf of the individual if he or she is no longer able to make decisions.
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