The PSDA and Treatment Refusal by a Depressed Older Patient Committed to the State Mental Hospital
Lee, Melinda A.
HEC (HealthCare Ethics Committee) Forum. 1993 Sep; 5(5): 289-301.
Since 1991, the Patient Self-Determination Act (PSDA) has required all health care institutions that receive Federal funds to inform patients upon admission of their rights to make decisions about medical care and to execute advance directives. Implementation of the PSDA presents a special challenge for state mental hospitals. The relevance and possible negative therapeutic impact of discussing end of life decisions at the time of an acute psychiatric admission has recently been raised in the literature. Other ethical dilemmas arising from the interplay between mental illness and informed consent for medical tretment, particularly for older patients committed to state mental hospitals, have been highlighted by the PSDA. In this article we discuss some of the issues raised by implementation of the PSDA in this setting.
Advance Directives; Aged; Allowing to Die; Artificial Feeding; Case Studies; Clinical Ethics; Clinical Ethics Committees; Competence; Consent; Decision Making; Depressive Disorder; Ethics; Ethics Committees; Health; Health Care; Hospitals; Informed Consent; Institutionalized Persons; Illness; Legislation; Life; Literature; Mental Institutions; Mental Hospitals; Mental Illness; Patient Care; Patients; Right to Die; Rights; Risks and Benefits; Treatment Refusal; Withholding Treatment;
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