Cambridge Quarterly of Healthcare Ethics

Special Section: The Patient Self-Determination Act

The Patient Self-Determination Act: A Cooperative Model for Implementation

Alexander Morgan Caprona1

a1 Henry W. Bruce University Professor of Law and Medicine and Co-Director, Pacific Center for Health Policy and Ethics, University of Southern California, Los Angeles, California

In 1990, I voiced strong doubts about a bill entitled the Patient Self-Determination Act (PSDA), which had been introduced in the U.S. Senate by John Danforth (R-MO) and Daniel Patrick Moynihan (D-NY). I hoped to see it defeated. In 1991, after the bill had become a small part of a massive status (the Omnibys Budget Reconciliation Act of 1990) adopted in the waning hours of the 101st Congress, I devoted countless hours to its implementation. I wanted to see it succeed. Why the change?