The New Patient Self-Determination Act

My latest Legal Briefing column, “The New Patient Self-Determination
Act,” has just been published in The Journal of Clinical Ethics 24(2).  

In this Article, I cover recent legal
developments involving the Patient Self-Determination Act (PSDA).  Enacted in
the wake of the U.S. Supreme Court’s Cruzan decision in 1990, the PSDA remains
a seminal event in the development of U.S. bioethics public policy.  But the
PSDA has long been criticized as inadequate and ineffective. Finally, recent
legislative and regulatory changes promise to revitalize and rejuvenate it.  I categorize new legal developments concerning
the PSDA into the following eight sections:

    1.  Background and History

    2.  Rules and Requirements

    3.  Criticism and Challenges

    4.  Failed Efforts to Amend
the PSDA

    5.  Personalize Your Care Act
of 2013

    6.  New Regulations

    7.  New Regulatory Guidance

    8.  Expanded Enforcement

Much of the rest of the Summer 2013 issue also concerns end-of-life and
surrogate decision making, so here is the complete TOC:

Why Careproviders May Conclude that Treating a Patient Is Futile

Edmund G. Howe

Repetitive Foreign Body Ingestion: Ethical Considerations

Sarah Lytle, Susan J. Stagno, and Barb Daly 

The Intensity and Frequency of Moral Distress Among Different
Healthcare Disciplines

Susan Houston, Mark A. Casanova, Marygrace Leveille, Kathryn L.
Schmidt,

Sunni A. Barnes, Kelli R. Trungale, and Robert L. Fine 

“He Got His Last Wishes”: Ways of Knowing a Loved One’s End-of-Life
Preferences and Whether Those Preferences Were Honored

Angelina R. Wittich, Beverly Rosa Williams, F. Amos Bailey, Lesa L.
Woodby, and

Kathryn L. Burgio 

Making Decisions for Hospitalized Older Adults: Ethical Factors
Considered by Family Surrogates

Jenna Fritsch, Sandra Petronio, Paul R. Helft, and Alexia M. Torke 

The Threshold Moment: Ethical Tensions Surrounding Decision Making on
Tracheostomy for Patients in the Intensive Care Unit

Arvind Venkat 

A Response to Dubler’s Commentary on “Surmounting Elusive Barriers: The
Case for Bioethics Mediation”

Edward J. Bergman 

 The Art of the Chart Note in Clinical Ethics Consultation and Bioethics
Mediation: Conveying Information that Can Be Understood and Evaluated

Nancy Neveloff Dubler 

 Legal Briefing: The New Patient Self-Determination Act

Thaddeus Mason Pope