Federal Legislation
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Federal legislation quickly followed the Cruzan decision. In 1990, the U.S. Congress passed the Patient Self-Determination Act (PSDA) as part of the Omnibus Budget Reconciliation Act. This bill mandated states to create advance directive laws and health care facilities participating in Medicare/Medicaid programs to provide written information about advance directives along with documenting whether or not the patient has any advance directives . The Uniform Health Care Decisions Act (UHCDA), drafted in 1993 by the National Conference of Commissioners on Uniform State Laws, consolidated the components of state advance directive laws including advance directives, signing requirements, surrogate or proxy designation, and organ/tissue donation. This act was not national legislation, but instead, the UHCDA served as a model for state laws, and many states have adopted the Act in its entirety or modified the Act for adoption .