The Federal Patient Self-Determination Act (PSDA) was meant to encourage the use of advance directives such as living wills and durable powers of attorney for health care. The PSDA changes key provisions in federal Medicare and Medicaid laws. It mandates that hospitals and other health care providers maintain explicit policies and procedures regarding five issues. The hospital or health care provider must:

1. provide written information regarding the individual’s rights under state law to make decisions concerning medical care, including the right to formulate advance directives.
2. note in the patient’s medical record whether the individual has executed an advance directive
3. not discriminate against a patient in response to the patient’s decision on an advance directive
4. comply with state laws concerning advance directives
5. create a policy to provide for education of its staff and community on issues concerning advance directives