Rights and responsibilities

December 02, 1991

Thanks to a new federal law, adult Americans will now get a timely reminder of their rights when they are admitted to health care institutions. The federal Patient Self-Determination Act, which went into effect Dec. 1, stipulates that all patients be told about the provisions their state makes for living wills and other advance directives in case they become unable to make decisions about their own medical care.

In recent years, medical technology has rapidly increased the number of tough life-and-death decisions that must be made each day in health care institutions. The Supreme Court has recognized the validity of advance directives, as well as the right of each state to set the requirements that govern them. But rights go hand-in-hand with responsibilities, and the real value of the new law may well lie in encouraging Americans to confront the reality that someone will be making decisions about their care if they become unable to do so.

About 2 million Americans die each year, about 80 percent of them in institutions; 70 percent of those deaths are the result of a decision made by someone other than the patient. Those numbers tell a sobering story: If Americans don't exercise their rights and responsibilities in end-of-life decisions, somebody else will have to do it for them. Is it fair to burden your family by making them play a guessing game about what you would want done?

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