Economic, political and ethnic influences on end-of-life decision-making: a decade in review

J Health Soc Policy. 2002;14(3):27-39. doi: 10.1300/J045v14n03_02.


Implementation of the Patient Self Determination Act (PSDA) a decade ago has been followed by considerable research examining usage of advance directives among patient populations as well as among health care professionals. This article summarizes the history of end-of-life medical treatment options and provides a discussion of critical economic, political, and legal events that preceded passage of the PSDA. A review of the literature during the decade that followed is presented including research exploring ethnic factors in the completion of advance directives. Barriers to completing advance directives by minority populations are discussed and considerations for policy makers are provided.

Publication types

  • Review

MeSH terms

  • Advance Directives*
  • Aged
  • Decision Making*
  • Ethnic Groups*
  • Health Services Research
  • Humans
  • Living Wills
  • Patient Participation
  • Patient Self-Determination Act*
  • Policy Making
  • Socioeconomic Factors
  • Terminally Ill*
  • United States