Can advance directives assure that patients' decisions will be considered?

When the Patient Self-Determination Act of 1990 was enacted, health care facilities were mandated to question all patients regarding their choices in health care matters. Since that time, advance directives have received mixed reviews from health care providers, patients, and families. Much of the controversy results because advance directives vary from state to state, are poorly understood by health care providers and patients, and the laws are stated in vaguely defined terms. Understanding the laws at the state and local level can help educate professionals, who can share this information with other staff members, family, and patients.