The Patient Self-Determination Act

Meeting the Challenges in Patient Care

Lawrence P. Ulrich

• Publisher: Georgetown University Press
• Year: 2001
• Print ISBN: 9780878407484, 9780878407477
• eBook ISBN: 9781589014534
• Topic: Medicine
• Subtopic: Ethics in Medicine

The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices.

According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient.

Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates.

Table of contents

• Cover
• Contents
• Introduction
• Chapter 1. The Requirements of the Patient Self-Determination Act
• Chapter 2. The Legal Background of the Patient Self-Determination Act
• Chapter 3. The Social and Technological Background for the Patient Self-Determination Act
• Chapter 4. The Human Context of the Patient Self-Determination Act
• Chapter 5. The Institutional Context of the Patient Self-Determination Act
• Chapter 6. The Ethical Foundations of the Patient Self-Determination Act
• Chapter 7. Advance Directives
• Chapter 8. The Roles of Healthcare Professionals
• Chapter 9. The Role of the Responsible Patient
• Conclusion
• Index