Legal briefing: The new Patient Self-Determination Act

Journal of Clinical Ethics

Volumn 24, Issue 2, 2013, Pages 156-167

  Pope, Thaddeus Mason ^a  

^a HAMLINE UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HUMAN; LEGAL ASPECT; LIVING WILL; PATIENT PARTICIPATION; PATIENT SELF-DETERMINATION ACT; UNITED STATES;

ADVANCE DIRECTIVES; HUMANS; LIVING WILLS; PATIENT PARTICIPATION; PATIENT SELF-DETERMINATION ACT; UNITED STATES;

EID: 84880403219     PISSN: 10467890     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (99)

1. T. M. Pope, "Legal Briefing: Advance Care Planning", The Journal of Clinical Ethics 20, no. 4(Winter 2009):289-96.
2. Sen. Danforth, "Patient Self-Determination Act", 35 Cong. Rec. S13. 564 (17 October 1989).
3. An exhaustive legislative history is provided in E. J. Larson and T. A. Eaton, "The Limits of Advance Directives: A History and Assessment of the PSDA", Wake Forest Law Review 32, no. 1(1997):249-93.
4. -497 U. S. 261 (1990).
5. W. Colby, Long Goodbye: The Deaths of Nancy Cruzan (Hay House, Carlsbad, Calif.: 2002).
6. Cruzan v. Harmon, 760 S. W.2d 408 (Mo. 1989).
7. Rep. Levin, "Introduction of the Patient Self-Determination Act", 136 Cong. Rec. H4222 (27 June 1990);
8. Rep. Levin, "Patient Self-Determination", 136 Cong. Rec. E2190 (28 June 1990).
9. A. Meisel and K. L. Cerminara, The Right to Die: The Law of End-of-Life Decisionmaking, 3rd ed. (New York: Aspen, 2013), § 7. 04[c].
10. -42 U. S. C. § 1395 cc (a) (1) (Q);
11. -42 U. S. C. § 1396 a (a) (57);
12. -42 U. S. C. § 1396r (c) (2) (E);
13. -42 U. S. C. § 1395i-3 (c) (1) (E);
14. -42 U. S. C. § 1395bbb (a) (6).
15. The PSDA also applies to Medicare HMOs. 42 U. S. C. § 1395mm (c) (8);
16. -42 U. S. C. § 1395w-22 (i).
17. Many of these same duties are separately imposed by Joint Commission accreditation requirements or by state law. The Joint Commission, 2013 Comprehensive Accreditation Manual for Hospitals (Oakbrook Terrace, 111.: Joint Commission, 2013), § RI.01.05.01;
18. -42 U. S. C. § 1395cc (f) (1) (A);
19. -42 U. S. C. § 1396a (w) (1) (A).
20. In the case of a hospital, this information must be provided upon admission. 42 U. S. C. § 1395cc (f) (2);
21. -42 U. S. C. § 1396a (w) (2).
22. -42 U. S. C. § 1395cc (f) (1) (B) - (E);
23. -42 U. S. C. § 1396a (w) (1) (B) - (E).
24. DHHS, "Medicare and Medicaid Programs; Advance Directives: Interim Final Rule", 57 Fed. Reg. 8, 194 (6 March 1992).
25. These regulations were later amended several times. DHHS, "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 1995 Rate", 59 Fed. Reg. 45, 403 (1 September 1994);
26. DHHS, "Medicare and Medicaid Programs; Advance Directives: Final Rule", 60 Fed. Reg. 33, 262 (27 June 1995);
27. DHHS, "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 1998 Rates: Final Rule", 62 Fed. Reg. 46, 037 (29 August 1997);
28. DHHS, "Medicare and Medicaid Programs; Religious Nonmedical Health Care Institutions and Advance Directives: Interim Final Rule", 64 Feg. Reg. 67, 052 (30 November 1999);
29. DHHS, "Medicare and Medicaid Programs; Religious Nonmedical Health Care Institutions and Advance Directives: Final Rule", 68 Fed. Reg. 66, 710 (28 November 2003).
30. DHHS, "Final Rule: Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions of Participation to Ensure Visitation Rights for All Patients", 75 Fed. Reg. 70, 831, 70, 841 (19 November 2010).
31. -42 C. F. R. § 482. 13 (b) (3). This regulation provides that patients have "the right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives, in accordance⋯ 489.102." The substantive PSDA requirements are included in
32. -42 C. F. R. § 489. 102.
33. -42 C. F. R. § 489. 102 (a) (1) (ii).
34. H. R. 1003, 105th Cong., 1st Sess. (1997) (Hall), enacted as
35. Pub. L. No. 105-12, § 7, (30 April 1997)
36. 111 Stat. 26
37. codified at 42 U. S. C. § 14406.
38. S. M. Wolf (et al)., "Sources of Concern about the Patient Self-Determination Act", New England Journal of Medicine 325, no. 23(1991):1666-71;
39. E. J. Emanuel (et al)., "How Well Is the Patient Self-Determination Act Working? An Early Assessment", American Journal of Medicine 95, no. 6(1993):619-28;
40. A. M. Capron, "The Patient Self-Determination Act: Not Now", Hastings Center Report 20, no. 5(September/October 1990):35-6;
41. M. A. Refolo, "Patient Self-Determination Act of 1990: Health Care's Own Miranda", Journal of Contemporary Health Law and Policy 8(1992):455-71.
42. L. P. Ulrich, The Patient Self-Determination Act: Meeting the Challenges in Patient Care (Washington, D. C.: Georgetown University Press, 2001);
43. G. Duke (et al)., "The PSDA 20 Years Revisited", Journal of Nursing Law 13, no. 4(2009):114-23;
44. A. W. Foster, "Bacon, Eggs, and Advance Directives: The PSDA 20 Years Later", University of Houston Health Law Perspectives (May 2011);
45. O. Ben-Shahar and C. E. Schneider, "The Failure of Mandated Disclosure", University of Pennsylvania Law Review 159, no. 3(2011):647-749;
46. E. H. Bradley (et al)., "Institutional Efforts to Promote Advance Care Planning in Nursing Homes: Challenges and Opportunities", Journal of Law, Medicine, and Ethics 25, no. 2 and 3(1997):150-59.
47. R. E. Shugrue, "The Patient Self-Determination Act", Creighton Law Review 26, no 3(1993):751-83;
48. L. Rutkow, "Dying to Live: The Effects of the PSDA on Hospice Care", NYU Journal of Legislation and Public Policy 7, no. 2(2004):393-435.
49. C. J. Jones, "Say What? How the PSDA Leaves the Elderly with Limited English Proficiency out in the Cold", Elder Law Journal 13, no 2(2005):489-518.
50. T. M. Pope, "The Maladaptation of Miranda to Advance Directives: A Critique of the Implementation of the Patient Self-Determination Act", Health Matrix 9, no. 1(1999):139-202.
51. Patient Self-Determination Act-Providers Offer Information on Advance Directives but Effectiveness Uncertain, GAO/HEHS Doc. No. 95-135 (1995).
52. D. Leahman, "Why the Patient Self-Determination Act Has Failed", North Carolina Medical Journal 65, no. 4(2004):249-51.
53. Resolution 106A, Adopted by the American Bar Association House of Delegates (6 August 2012), http://www.abanow.org/2012/06/2012am 106a/, accessed 3 June 2013. The resolution further encouraged requiring "the annual Medicare wellness examination, or other periodic doctor-patient interactions, to include both an opportunity to engage in and assistance with have resource options available relating to advance care planning for health decisions"
54. American Academy of Nursing, "Policy Brief: Advance Care Planning as an Urgent Public Health Concern" (15 April 2013), http://www.aannet.org/ policy-brief-advance-care-planning-as-an-urgentpublic-health-concem-2013-, accessed 3 June 2013.
55. D. B. White and T. M. Pope, "The Courts, Futility, and the Ends of Medicine", Journal of the American Medical Association 307, no. 2(2012):151-52.
56. Until Vermont legalized physician aid-in-dying in May 2013, no U. S. state had done that through legislation. The Death with Dignity Acts in Washington and Oregon were enacted through ballot initiatives. Montana legalized aid-in-dying through a court decision. P. Span, "Vermont Passes 'Aid in Dying' Measure", New York Times, New Old Age Blog (14 May 2013).
57. In re Jane Doe, 45 Pa. D. and C.3d 371 (1987).
58. -42 U. S. C. § 1395x (ww).
59. -42 U. S. C. § 1395x (ww) (3).
60. C. P. Sabatino, "The Evolution of Health Care Advance Planning Law and Policy", Milbank Quarterly 88, no. 2(2010):211-39.
61. G. Kessler, "Sara Palin, Death Panels, and Obamacare", Fact Checker (27 June 2012), http://www.washingtonpost.com/blogs/fact-checker/post/ sarah-palin-death-panels-and-obamacare/2012/06/27/gJQAysUP7V-blog.html, accessed 3 June 2013.
62. DHHS, "Medicare Program: Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2011", 75 Fed. Reg. 73, 170 (29 November 2010).
63. R. Pear, "U. S. Alters Rule on Paying for Endof-Life Planning", New York Times, 4 January 2011;
64. DHHS, "Medicare Program: Amendment to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2011", 76 Fed. Reg. 1366 (10 January 2011).
65. The bill would amend 42 U. S. C. § 1395x (s) by expanding the definition of "medical and other health services"
66. I comprehensively covered recent legal developments concerning POLST in T. M. Pope and M. Hexum, "Legal Briefing: POLST (Physician Orders for Life Sustaining Treatment)", The Journal of Clinical Ethics 23, no. 4(Winter 2012):353-76.
67. http://www.polst.org, accessed 3 June 2013.
68. -42 C. F. R. §§ 495. 2 to 495.370.
69. -42 C. F. R. §§ 495. 6 (g) (2) and 495.6 (m);
70. http://cms.gov/regulations-and-guidance/legislation/ehrincentiveprograms/ , accessed 3 June 2013.
71. http://www.whitehouse.gov/the-press-office/presidential-memorandum- hospital-visitation, accessed 3 June 2013;
72. -75 Fed. Reg. 20, 511 (15 April 2010).
73. DHHS, "Proposed Rule: Medicare and Medicaid Programs: Proposed Changes Affecting Hospital and Critical Access Hospital (CAH) Conditions of Participation (CoPs): Credentialing and Privileging of Telemedicine Physicians and Practitioners", 75 Fed. Reg. 29, 479 (26 May 2010).
74. DHHS, "Final Rule: Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions of Participation To Ensure Visitation Rights for All Patients", 75 Fed. Reg. 70, 831 (19 November 2010).
75. Centers for Medicare and Medicaid Services, "Survey and Certification Letter 12-47", 27 September 2012, http://www.cms.gov/ Medicare/Provider-Enrollment-and-Certification/SurveyCertification GenInfo/Downloads/Survey-and-Cert-Letter-12-47.pdf, accessed 3 June 2013.
76. DHHS, Medicare and Medicaid Programs; Hospital Conditions of Participation: Patients' Rights, 64 Fed. Reg. 36, 070 (2 July 1999).
77. Centers for Medicare and Medicaid Services, "Survey and Certification Letter 11-36: Hospital Patients' Rights to Delegate Decisions to Representatives; New Hospital and Critical Access Hospital (CAH) Patient Visitation Regulation", 7 September 2011, http://www.cms.gov/Medicare/ Provider-Enrollm ent-and-Certification/S u rveyCertification Genlnfo/Downloads/Survey-and-Cert-Letter-11-36-Part-I.pdf, accessed 3 June 2013.
78. Centers for Medicare and Medicaid Services, "CMS Manual System: Pub 100-07 State Operations Provider Certification: Transmittal 75", 2 December 2011, http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/ downloads/R75SOMA.pdf, accessed 3 June 2013.
79. http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/Survey CertificationGenlnfo/Downloads/Survey-and-Cert-Letter-13-16.pdf, accessed 3 June 2013. Around this same time, CMS released updated interpretive guidelines to CMS state survey agencies and CMS regional offices clarifying the obligations of ambulatory surgery centers to honor advance directives.
80. see also J. K. Feldkamp, "Four Recent Releases by CMS for Nursing Facilities", American Health Lawyers Association, December 2012, p. 1, http://rn. babc.com/files/Publication/dl7cf251-c6ae-49ba-88b4-391f51ad6246/ Presentation/PublicationAttachment/27ac985a-877d-43c7-bf47-ad2950933457ZLTC- Dec12.pdf, accessed 3 June 2013.
81. Scheible v. Joseph L. Morse Geriatric Center, 988 So. 2d 1130, 1132 (Fla. App. 2008);
82. Turner v. Jackson Park Hosp., 264 Fed. Appx. 527 (7th Cir 2008);
83. Asselin v. Shawnee Mission Med. Ctr., 894 F. Supp. 1479 (D. Kan. 1995).
84. While patients and families have no cause of action under the PSDA, they can often sue under other laws such as state healthcare decisions acts and state common law. T. M. Pope, "Clinicians May Not Administer Life-Sustaining Treatment without Consent: Civil, Criminal, and Disciplinary Sanctions", Journal of Health and Biomedical Law 9, no. 2(2013):101-84.
85. DHHS, "Medicare and Medicaid Programs; Hospital Conditions of Participation: Patients' Rights", 64 Fed. Reg. 36, 070 (2 July 1999).
86. http://www.hospitalinspections.org/ (searched "advance directive" and "tag A0132"), accessed 3 June 2013.
87. http:/Vwww.hhs.gov/dab/, accessed 3 June 2013
88. http://www.hhs.gov/dab/decisions/index.html (searched "advance directive"), accessed 3 June 2013.
89. Kentucky Cabinet for Health and Family Services, "Health Care and Long Term Care Applications", 10 January 2011, http://chfs.ky.gov/os/oig/ ltcappls.htm, accessed 3 June 2013.
90. R. Mullman, "Nursing Homes Ignorant of DNR Purpose and Policy", S. C. Nursing Home Blog, 25 May 2009, http:/Zwww.scnursinghomelaw.com/2009/05/ articles/regulatory-enforcement/nursinghomes-ignorant-of-dnr-purpose-and-policy/ , accessed 3 June 2013.
91. "Resuscitation Orders Not Always Followed in Kentucky", Independent Online, 22 March 2009, http://dailyindependent.com/local/xl 192779354/Resuscitation-orders-not-always-followed-in-Ky, accessed 3 June 2013.
92. DHHS Centers for Medicare and Medicaid Services, "Survey of Consulate Health Care of Woodhaven No. 105998", 2012, http://www.medicare. gov/nursinghomecompare/SurveyReport Detail.aspx?ID=1059988JSURVEYDATE= June%20%208,%202012&'AspxAutoDetectCooldeSupport=1, accessed 3 June 2013.
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95. Evergreen Commons v. CMS, No. CR2372 (20 May 2011), http://www.hhs.gov/ dab/decisions/civildecisions/cr2372.pdf, accessed 3 June 2013.
96. -42 U. S. C. 1395cc (f) (1) (A).
97. http://www.hospitalinspections.org/report/1734, accessed 3 June 2013.
98. http://www.hospitalinspections.org/report/964, accessed 3 June 2013.
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