A female patient with end-stage pancreatic cancer was admitted from hospice for a celiac plexus block to treat intractable pain.She wanted to be able to complete "getting her things in order" and saying good-bye to her friends and family while enjoying her last days pain-free.The patient insisted that her Do Not Resuscitate (DNR)status NOT be rescinded.She was conscious and competent and knew what was best for herself.The patient was taking full advantage of what provision for her care?

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Many individual states had statutes that allowed patients to dictate their future healthcare wishes in a legally recognized fashion if they were unable to do so when a life-threatening situation arose.Then,in the wake of the first U.S.Supreme Court case to deal with the issue-Cruzan v.Director,Missouri Department of Health,497 U.S.261 (1990)-the U.S.Congress in 1991 passed the PSDA to extend legal protection to all U.S.citizens and residents.Under the Act,patients have the legal right to accept or refuse medical treatment,including resuscitation,even if refusal will likely result in death.

A Female Patient with End-Stage Pancreatic Cancer Was Admitted from Hospice