Legal Briefing: the New Patient Self-Determination Act

This issue's "legal briefing" column covers recent legal developments involving the Patient Self-Determination Act (PSDA). Enacted in the wake of the U.S. Supreme Court's Cruzan decision in 1990, the PSDA remains a seminal event in the development of U.S. bioethics public policy, but the PSDA has long been criticized as inadequate and ineffective. Finally, recent legislative and regulatory changes promise to revitalize and rejuvenate it. The PSDA has been the subject of recent articles in The Journal of clinical ethics.' I categorize new legal developments concerning the PSDA into the following eight sections: (1) Background and history (2) Rules and requirements (3) Criticism and challenges (4) Failed efforts to amend the PSDA (5) Personalize your Care Act of 2013 (6) New regulations (7) New regulatory guidance (8) Expanded enforcement.