The law was enacted in order to encourage individuals to make advance health care decisions regarding life-sustaining care.  It was not until after enactment that the value of advance directives in psychiatric care was seriously considered.   

With respect to psychiatric advance directives (PADs), there is considerable interest among individuals at risk of psychiatric crises in creating a psychiatric advance directive, but attitudes of clinicians about PADs are associated with this interest.   As a result PADs are not yet widely used.  However, as PADs become more popular, they could usher in a new era of revolution in medical decision making, greatly increasing patient authority over medical decisions.