I personally choose the topic entitled “Nursing and The Patient Self

Determination Act”. which became effective on December 1, 1991. The legislation

mandated many hospitals, nursing homes, home health agencies, hospice providers,
HMOs, and other health care institutions to give information about advance health
care directives to adult patients upon their admission to the healthcare facility. This
law does not apply to individual doctors.

The purpose of the Patient Self-Determination Act is to inform patients

of the rights of adults to refuse life-sustaining treatments that are being
communicated by their health care provider. Specifically, the rights assured are those
of the patient to direct their future care (by means such as living will or the power of
an attorney), should they become incapacitated. The rights of the adult patient under
the state of laws governing advance directives was also an required information by
the PSDA Including: 1) the right to accept or refuse medical or surgical treatment;
2) the right to participate in and direct their own healthcare decisions; 3) the right
to ready an advance directive; 4) facts on the provider’s policies that preside the
utilization of these rights. The act also forbid institutions from discriminating against
a patient who does not have an advance directive. Furthermore, Institutions to
document patient information and provide ongoing community education on
advance directives.

In the Philippines we have the Patient self- determination act wherein ,

The rights under state law to make health care decisions and to make "advance
directives,” such as durable powers of attorney for health care and living wills
was required. The providers should inform patients about it.. The PSDA could end
up as just one more federal bureaucratic intrusion into health care that increases its
cost while enhancing neither its effectiveness nor its humanism. To enhance the
quality of patient decisionmaking and planning for future illness, The providers
should treat it as an opputunity to work with their staff (Including Attending
Physicians) for better outcome. With that said, the real discussions were needed to
create useful advance directives can go on among patients, their family members,
and the health care professionals who care for them.

The American Nurses Association recommends that nurses advocate

for the participation of patients in end-of-life decisions and that nurses and other
professional healthcare provider first should have a better understanding of what
anf how an advance directive (AD) is executed correctly. Both the healthcare
provider and the patient are confused with Advance directives. Poor rates of
completion were contributed by complexity. Yet as much as possible, the
professional association asserts that nurses should be aware of the legalities
associated with ADs.

In Conclusion, While an advance directive is useful and advantagious

method of exercising one’s natural right to create decisions concerning health care,
but the sledge hammer approach of the PSDA will give more problems than it solves.
Clearly, medical care should be decline and life support should be removed if they
are not advantagious for the patient. However, deciding what is advantagious is an
act of love on the part of the proxy, and an act of advocacy on the part of the
physician. When adequate communication and empathy precede medical decision
making both love and advocacy is nurtured.

References:
ANA position statement on nursing and the Patient Self-Determination Act. (n.d.).
Retrieved December 3, 2018, from
https://www.ncbi.nlm.nih.gov/pubmed/1635900
Buford, C. (2017). Corrigendum: Advance directives and knowledge of future
selves. Palgrave Communications,3, 17098. doi:10.1057/palcomms.2017.98
Sources of Concern about the Patient Self-Determination Act. (n.d.). Retrieved
December 3, 2018, from
https://www.nejm.org/doi/full/10.1056/NEJM199112053252334
The Patient Self‐Determination Act. (n.d.). SpringerReference.
doi:10.1007/springerreference_61535