Iserson K V
Center for Clinical Medical Ethics, Pritzker School of Medicine, University of Chicago, Illinois.
J Emerg Med. 1991;9 Suppl 1:67-70. doi: 10.1016/0736-4679(91)90591-3.
On December 1, 1991, a new federal law designed to increase public use of advance directives takes effect. After that date, health care facilities must provide written information about advance directives to all adult patients. This information must describe (1) the patient's rights to make medical care decisions under state statutes and case law, and (2) how patients can secure these rights within the scope of the provider's policies. The law also requires that institutions educate their staffs and the communities about advance directives and document the existence of any advance directive in the patient's medical record. The new federal law will benefit American society, U.S. health care, and the practice of emergency medicine. However, emergency physicians should anticipate that the law will provide not only benefits, but also some burdens. Many institutions will expect emergency department personnel to disseminate and explain the required information, and annotate the medical record. It is the specialty's responsibility to gather empirical data that can guide the use of advance directives in emergency departments.
1991年12月1日，一项旨在增加公众对预立医疗指示使用的新联邦法律生效。自该日起，医疗机构必须向所有成年患者提供有关预立医疗指示的书面信息。此信息必须描述：（1）根据州法规和判例法，患者做出医疗护理决定的权利；（2）患者如何在医疗机构政策范围内确保这些权利。该法律还要求机构对其工作人员和社区进行有关预立医疗指示的教育，并在患者病历中记录任何预立医疗指示的存在情况。新联邦法律将使美国社会、美国医疗保健以及急诊医学实践受益。然而，急诊医生应预料到该法律不仅会带来益处，也会带来一些负担。许多机构会期望急诊科人员传播并解释所需信息，并在病历中进行注释。收集能指导急诊科使用预立医疗指示的实证数据是该专业的责任。
