Discussion: The Patient Self-Determination Act HLT 308V

Discussion: The Patient Self-Determination Act HLT 308V

Topic 3 DQ 1: The Patient Self-Determination Act

               The Patient Self-Determination Act (PSDA) was adopted to ensure the safeguarding and communication of the rights of the patient to self-determination in healthcare decision-making. This Act empowers patients to make independent decisions about resuscitation in situations where they cannot breathe or experience heart failure (Teoli & Ghassemzadeh, 2019). The Act also permits the use of DNR order in specific situations such as where the burdens are heavier than the benefits, where resuscitations cannot benefit the individual, and where resuscitation cannot initiate the breathing process or restore heart failure (Teoli & Ghassemzadeh, 2019). An ethics committee is instrumental in enforcing the advance directives of the patients in their care. Before execution of the directives, the committee must document the directive in the medical records and talk about the directive with the patient or the family members of the patient if it is impossible to involve the patient.                The ethics committee is also expected to explore the probability of restarting the breathing or heart of the patient before resuscitation and the likelihood of quality of life after the resuscitation. After making this determination, it is imperative to engage the patient or family on the decision (Reyes, 2021). The ethics committee is also required to take measures to ensure that the DNR order is not violated and does not cause unethical practices. The committee must ensure that the order is not infringed, especially when executed without the knowledge of the patient or family. The committee should also intervene to safeguard the patients against the order when the relatives violate the order. The committee must also ensure that the advance directives of the DNR order do not influence the healthcare delivery process (Andreasen et al., 2019).

References

Andreasen, P., Finne-Soveri, U. H., Deliens, L., Van den Block, L., Payne, S., Gambassi, G., … & Szczerbińska, K. (2019). Advance directives in European long-term care facilities: a cross-sectional survey. BMJ Supportive & Palliative Care. http://dx.doi.org/10.1136/bmjspcare-2018-001743

Reyes, G. (2021). The Effects of the Patient Self-Determination Act of 1990 on Patient Rights and the Healthcare Setting. California State University, Long Beach.

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Teoli, D., & Ghassemzadeh, S. (2019). Patient self-determination Act. https://europepmc.org/article/NBK/nbk538297

Discussion: The Patient Self-Determination Act HLT 308V

HLT 308V Topic 3 DQ 1

The Patient Self-Determination Act (PSDA) was implemented to allow patients to state “Do Not Resuscitate” (DNS), or to assign a surrogate decision maker in the event that the individual is unable to make the decision. What relationship does an ethics committee have in enforcing the advance directives of the patients in their care? Support your analysis with a minimum of one peer-reviewed article.

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Discussion: The Patient Self-Determination Act HLT 308V
Discussion: The Patient Self-Determination Act HLT 308V

Patient Self Determination Act of 1990 – Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require hospitals, skilled nursing facilities, home health agencies, hospice programs, and health maintenance organizations to: (1) inform patients of their rights under State law to make decisions concerning their medical care; (2) periodically inquire as to whether a patient executed an advanced directive and document the patient’s wishes regarding their medical care; (3) not discriminate against persons who have executed an advance directive; (4) ensure that legally valid advance directives and documented medical care wishes are implemented to the extent permitted by State law; and (5) provide educational programs for staff, patients, and the community on ethical issues concerning patient self-determination and advance directives.

Discussion: The Patient Self-Determination Act HLT 308VDirects the Secretary of Health and Human Services to: (1) arrange with the Institute of Medicine of the National Academy of Sciences for a study assessing the implementation of directed health care decisions; and (2) develop and implement a demonstration project in selected States to inform the public of the option to execute advance directives and a patient’s right to participate in and direct health care decisions.

Discussion: The Patient Self-Determination Act HLT 308VBecause the 1991 PSDA does not apply to individual physicians, private clinics and practices, most of which are incorporated for-profit organizations, the problem of cruel over treatment for profit of the elderly on Medicare/Medicaid was not controlled to the extent that Congress hoped would be possible when the states would implement the goals of the 1991 PSDA in state laws. (Recently, in 2012, the newspapers have revealed that The United States Department of Health and Human Services and the Department of Justice have cooperated to prosecute over treatment of patients under the federal False Claims Act.) The goals of the 1991 PSDA are covered in the PURPOSE section, below.

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