ABSTRACT
This chapter describes the Self-Determination Act of 1990 and its expected practical and legal effects. It examines the preventive measures required by the Act. The chapter focuses on the Act's failure to create for patients substantive rights that would eliminate the problems surrounding termination of life-sustaining treatment. The Patient Self-Determination Act of 1990 helps to reduce the devastating uncertainty accompanying the patient's right to die by encouraging patients to clarify before the onset of incompetency their intentions regarding life-support. The Act conditions health-care providers' participation in Medicare and Medicaid programs on their distributing written information to each adult individual receiving medical care. Some opponents of the Act claim that health-care providers could use the opportunity created by the Act to persuade and manipulate mentally and financially disadvantaged patients to forego life-sustaining intervention, thereby decreasing the cost to the state of providing medical care to them.
