Patient Self Determination Act of 1990

Patient Self Determination Act of 1990 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require hospitals, skilled nursing facilities, home health agencies, hospice programs, and health maintenance organizations to: (1) inform patients of their rights under State law to make decisions concerning their medical care; (2) indicate in the patient's medical record whether he or she has executed an advance directive; (3) not discriminate against persons who have executed an advance directive; (4) ensure compliance with State law regarding advance directives; and (5) educate their staff and the community on issues concerning advance directives.

Directs the Secretary of Health and Human Services to: (1) arrange with the Institute of Medicine of the National Academy of Sciences for a study regarding the context in which directed health care decisions are made and carried out; and (2) develop and implement a demonstration project in selected States to inform the public of the option to execute advance directives and a patient's right to participate in and direct health care decisions.