United States laws that pertain to the rights of terminally ill patients include both Federal law and the laws of the individual States. These laws affect the structure and use of Advance Directives that patients prepare to provide guidance and direction as to how they wish to be treated in the event of their mental and physical incapacity. The manner by which individuals are treated when they lose decisional capacity may be subject to decisions of federal courts and ultimately the United States Supreme Court. These decisions address the balance between an individual's autonomy to direct how he or she wishes to be cared for when no longer capable of making personal decisions, the role and rights of designated decision makers for such individuals, and the role and authority of States to direct how such care can or should be provided. A separate set of decisions pertain to the issue of physician-assisted suicide. These again seek to balance the rights of individuals versus the authority and responsibility of government. As with decisions affecting care of the terminally ill, decisions arise from State law but may end up in judicial decisions of the United States Supreme Court. The decisions by the United States Supreme Court have resulted in differences among the States as to how physician-assisted suicide is managed. Finally, recent decisions have affected the access of terminally ill patients to drugs that have not been approved by the United States Food and Drug Administration (FDA) for general use. They address the rights of terminally ill patients to unapproved drugs versus the authority and responsibility of the FDA to regulate the availability of drugs.