In 1990 the Patient Self Determination Act was passed in the US. It required that patients be informed of their right to be involved in decision making with regards to the medical care they receive. It is also required that the patient is asked about advanced directives, and to document any wishes the patient might have with regard to the care they want or do not want (Teoli and Ghassemzadeh, 2020). As we think about the future of health care and the impact on the life span, what are the implications for the PSDA?