The biggest leap forward so far came with enactment of the Patient Self-determination Act. It requires institutions that receive Medicare and Medicaid to inform adult patients about directives, provide forms and record the information. However, the research in JAMA suggests the intent of the act is blunted by factors including overreliance on harried admissions clerks or sick patients and their families to ensure that the directives are available for use. So equally important to filling out the forms is that dependable mechanisms be put into place for locating advance directives when needed. The advance directives kit contains a special wallet card detailing where instructions can be found.
Advance directives are a positive change, one that empowers patients.
But there is a long way to go before the goal will be reached of making them a routine part of patient care. The forms are also available on this web site .