The PSDA and treatment refusal by a depressed older patient committed to the state mental hospital

Melinda A. Lee, Linda Ganzini, Ronald Heintz

    Research output: Contribution to journalArticle

    4 Scopus citations


    Since 1991, the Patient Self-Determination Act (PSDA) has required all health care institutions that receive Federal funds to inform patients upon admission of their rights to make decisions about medical care and to execute advance directives. Implementation of the PSDA presents a special challenge for state mental hospitals. The relevance and possible negative therapeutic impact of discussing end of life decisions at the time of an acute psychiatric admission has recently been raised in the literature. Other ethical dilemmas arising from the interplay between mental illness and informed consent for medical treatment, particularly for older patients committed to state mental hospitals, have been highlighted by the PSDA. In this article we discuss some of the issues raised by implementation of the PSDA in this setting.

    Original languageEnglish (US)
    Pages (from-to)289-301
    Number of pages13
    JournalHEC Forum
    Issue number5
    StatePublished - Sep 1 1993



    • PSDA
    • bipolar disorder
    • civil commitment
    • depression
    • elderly mania
    • mental hospital
    • treatment refusal

    ASJC Scopus subject areas

    • Issues, ethics and legal aspects
    • Health(social science)
    • Health Policy

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