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Problems and Solutions in End-of-Life Healthcare

Federal legislation passed in 1990 affirms patients' rights to document end-of-life wishes and designate a healthcare decision maker, requiring hospitals to ask all patients at time of admission about their advance directives. However, despite passage of this legislation—the Patient Self Determination Act of 1990—only 15% to 20% of patients have an advance directive, and even when there is one, 65% to 76% of physicians are unaware of these patient choices. Consequently, people end up getting healthcare services in the last days of life that they would not have wanted.
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