Special report: sources of concern about the patient self-determination act

Article Abstract:

The Patient Self-Determination Act of 1990 went into effect on December 1, 1991. The purpose of this Congressional act was to provide a set of statutes specifying the rights of patients to refuse life-sustaining treatments, particularly by using advance directives. The law is intended to encourage patients to specify, in writing, their desires concerning possible life-sustaining treatment in the event that, at some future date, they become seriously ill or injured and are not able to specify their desires at that time. The law also provides for the specification of a proxy, a person who would be entrusted with such decisions if the patient becomes incapacitated. Another purpose of the law is to encourage medical practitioners to recognize and honor advance directives when they exist. Some studies suggest that advance directives may be ignored in one-quarter of all cases. Despite the efforts of Congress reflected in the Act, there remains considerable concern in the medical profession about the actual implementation of advance directives concerning health care. Some of these concerns are based on erroneous beliefs. The authors provide a detailed discussion of some of the concerns about the Patient Self-Determination Act. One concern is that it will be difficult to talk with patients about possible mental incompetence and death. Evidence suggests that this concern is unfounded; patients appear to want to discuss their wishes and their concerns with their physicians. Physicians are also concerned that all these hypothetical discussions will take too much time from the practice of medicine. Physicians should realize that they are not alone and that other staff may provide an important source of information for patients. A more serious concern is that decisions made about hypothetical future illnesses may simply be too vague when a real illness actually incapacitates the patient. For this reason, the advance directives of patients should not use terms like ''extraordinary means of resuscitation,'' which are intrinsically vague. Whenever possible, the advance directive should indicate specific treatment methods that are to be used or not used and also define specific conditions under which such decisions are to be made. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Editorial, Laws, regulations and rules, Patients, Medical policy, Health policy, Right to refuse treatment, Right to die, Treatment refusal, Medical law

---

The politics of human-embryo research - avoiding ethical gridlock

Article Abstract:

Scientists must develop a new argument to convince Congress to fund embryo research. The Human Embryo Research Panel was created in 1994 to recommend which types of embryo research should be funded, but their recommendations have been ignored. This probably occurred because embryo research is linked to abortion. In January, 1996, Pres Clinton prohibited the use of federal funds for embryo research. Many people cannot accept creating embryos specifically for research because this would involve treating human embryos as commodities. However, they might accept research on spare embryos that were created during in vitro fertilization and other fertility treatments. A 1995 Congressional amendment to permit federal funding for research on spare embryos failed only because the vote was tied. By linking embryo research to research on infertility, scientists might have a better chance of gaining Congressional support.

Research, Political aspects, Medical research, Human embryo

---

Similar abstracts:

• Abstracts: Should nurses give medication without the patient's consent? Applying clinical governance in hospice care
• Abstracts: Analyzing hospital mortality: the consequences of diversity in patient mix. The importance of severity of illness in assessing hospital mortality
• Abstracts: Survival following diagnosis of Kaposi's sarcoma for AIDS patients in San Francisco. Survival trends for patients with AIDS
• Abstracts: Seroprevalence of Helicobacter pylori infections in Thailand. Microvillus inclusion disease: an inherited defect of brush-border assembly and differentiation
• Abstracts: Bacterial vaginosis: current review with indications for asymptomatic therapy. Statistical evaluation of diagnostic criteria for bacterial vaginosis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.