Does the patient self-determination act work?

H. S. Perkins, K. Artnak, J. D. Supik, H. P. Hazuda

Research output: Contribution to journalArticlepeer-review


The Patient Self-Determination Act of 1990 (PSDA) requires hospitals to educate their patients about advance directives (ADs), but almost no research has tested the law's impact. To address the issue, we surveyed newly admitted patients at a private hospital and a public hospital. We interviewed the patients and reviewed their medical records for documented education about ADs. Over 15 months we recruited 54 patients, of whom 46 had complete data. There were 16 nonHispanic Whites, 11 African Americans, and 19 Mexican Americans. Fourteen patients were over age 65, and 21 were men. Three of the 46 patients (7%) had signed an AD. Of the other 43, 21 (49%) had heard of ADs before hospitalization, 10 (23%) said they remembered a hospital staff member's talking with them about ADs, and the records of 18 (42%) documented information given about ADs. Patients at the private hospital were almost twice as likely as patients at the public hospital to have heard about ADs (75% versus 43%) and to have had a staff member talk with them about ADs (38% versus 20%). In addition, non-Hispanic Whites were more likely than African Americans or Mexican Americans to have heard of ADs (92% versus 36% and 24%), and to remember a staff member's talking with them about ADs (31% versus 18% and 24%). The impact of the PSDA on inpatients without ADs is small and may be limited by hospital and culture.

Original languageEnglish (US)
Pages (from-to)84A
JournalJournal of Investigative Medicine
Issue number1
StatePublished - 1996

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology


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