The Patient Self-Determination Act (PSDA)

Legal provisions within the health care sector allow patients in hospitals or nursing homes to express their acceptance or refusal of the administration of various medical procedures in case their health deteriorates to a state whereby they can no longer make sound decisions. The PSDA encourages health care providers to respect patients’ acceptance or refusal of particular medical procedures as stipulated in the advanced directive. The advanced directive encompasses instructions based on state laws regarding an individual’s rights to participate in various aspects of health care.

The Texas Advance Directives Act regulates the practice of health care providers in the administration of treatment. The Act highlights situations in which a physician violates the advance directive of a patient and recommends that a medical committee should review the physician’s actions and dictates appropriate procedures. Furthermore, the Act requires the medical committee to provide the patient or person responsible for health care decisions with a written description of the committee’s decision on the treatment approach. The Act obliges health care facilities to administer life-sustaining treatment during the review of the advanced directives regarding a patient (Herring, 2006).

Texas laws regarding health and safety prohibit medical procedures undertaken to intentionally cause the death of a patient. In this regard, health care providers in Texas are liable for any activities perceived as euthanasia. However, Texas laws allow medical procedures and practices that allow a patient to die a natural death. Thus, advanced directives recommended the withdrawal of life-sustaining procedures to permit a natural death to lie outside the scope of assisted suicide. The hospital should determine whether Susan created an advanced directive at the time of admission to the hospital. The analysis of the advanced directive should entail decisions regarding the administration of certain medical procedures and determine the incorporation of Susan’s husband’s decision is in the advanced directive.

Furthermore, the hospital should substantiate the provisions in the advanced directive by consulting with the relevant indemnity organization. In case Susan has a valid advanced directive, which conflicts with her husband’s decision, the hospital should not accept the recommendations on withdrawing the artificial processes. However, if Susan did not prepare an advanced directive, the hospital should engage Susan’s husband in the treatment decision as required by the PSDA.

In addition, the hospital should request the intervention of an attorney to confirm the authority of Susan’s husband concerning her treatment decisions An advanced directive incorporates several restrictions that may invalidate the directive or prohibit family members from making treatment decisions on behalf of a patient (Morrison & Monagle, 2009). By the Texas law on assisted suicide, an advanced directive should not incorporate procedures to cause unnatural death.

Another consideration is the changes in Susan’s initial treatment, which may introduce factors that invalidate the advanced directive.

Dispute regarding the decision capacity in the treatment of a patient may require the intervention of a court to determine the appropriate approach. The court will determine the level of a patient’s incapacitation in decision-making and the effectiveness of a physiatrist evaluation in the case of a conscious patient. For unconscious patients, the court will determine the appropriateness of the transfer of the decision-making capacity to a third party. Furthermore, the court identifies conflicts in treatment decisions in situations whereby the administration of treatment incorporates a variety of medical procedures some of which are unacceptable to the patient.

References

Herring, J. (2006). Medical law and ethics. Oxford: Oxford University Press.

Morrison, E. E., & Monagle, J. F. (2009). Health care ethics: critical issues for the 21st century (2nd ed.). Sudbury, Mass.: Jones and Bartlett Publishers.

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StudyCorgi. 2022. "The Patient Self-Determination Act (PSDA)." April 16, 2022. https://studycorgi.com/the-patient-self-determination-act-psda/.

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