Attitudes toward advance directives and advance directive completion rates

The Patient Self-Determination Act (PSDA) (part of the Omnibus Budget Reconciliation Act of 1990) requires that all healthcare institutions receiving Medicare and Medicaid funds inform patients about their right to participate in healthcare decisions, including their right to have an advance directive. Advance directives (ADs) allow an individual to participate indirectly in future medical care decisions if he or she becomes decisionally incapacitated. Despite passage of this bill and mechanisms within most healthcare institutions to provide this information, the AD completion rate remains low.