The Patient Self-Determination Act of 1990 directly affects social work clients and social work practice (and social work paperwork). Among other things, it made advance directives a required part of health care. summarizes:

The 1990 Patient Self-Determination Act (PSDA) encourages everyone to decide now about the types and extent of medical care they want to accept or refuse if they become unable to make those decisions due to illness. The PSDA requires all health care agencies to recognize the living will and durable power of attorney for health care. The Act applies to hospitals, long-term care facilities, and home health agencies that get Medicare and Medicaid reimbursement. Under the PSDA, health care agencies must ask you whether you have an advance directive. They also must give you information about your rights under state law.

Without knowing the history leading up to the bill, you can more-or-less figure it out based on its provisions. Wikipedia spells them out at greater length:

The requirements of the PSDA are as follows:

-Patients are given written notice upon admission to the health care facility of their decision-making rights, and policies regarding advance health care directives in their state and in the institution to which they have been admitted. Patient rights include:

  • The right to facilitate their own health care decisions

  • The right to accept or refuse medical treatment

  • The right to make an advance health care directive

-Facilities must inquire as to whether the patient already has an advance health care directive, and make note of this in their medical records.

-Facilities must provide education to their staff and affiliates about advance health care directives.

-Health care providers are not allowed to discriminately admit or treat patients based on whether or not they have an advance health care directive.

Once you've read this--or lived it as a social worker, health care receiver, caretaker, or planner--you're likely well prepared for a social work licensing exam question on the topic. You may see something as simple as this:

Which of the following requires health care facilities to discuss patient decision-making rights upon admission?

What goes in the list is up to the exam writer. The Civil Rights Act of 1964. Advance Directives. The Patient Decision-Making Rights Act of 1990 (made up). You know the correct answer. The PSDA, of course!

Find more about the PSDA here:

For realistic exam questions that test your knowledge about a wide range of social work topics, get started with SWTP by signing up!


[Post by Will Baum, LCSW]

March 9, 2016
Categories :