What is a POLST, and do I need one?

Doctor-80445_640Attorneys, including our office, are constantly educating the public on the importance of having a Health Care Directive consisting of a Health Care Power of Attorney and a Living Will, also known as an Advance Directive.

Although advance directives provide general guidance on what type of care a patient desires, they are not always followed. 

The Physician Orders for Life-Sustaining Treatment (POLST) is a complimentary document which has been implemented in a number of states, including Pennsylvania. The POLST uses a standardized medical order form to indicate which types of life-sustaining treatment a seriously ill patient wants or doesn't want if his or her condition worsens.

The POLST is designed to help primary care physicians, nurse practitioners, physician assistants, long-term care facilities, hospices, home health agencies, emergency medical services, and emergency physicians: 

  • promote a person’s autonomy by documenting a person's treatment preferences and coordinating these with medical orders; 
  • enhance the HIPAA-compliant transfer of patient records between health care professionals and health care settings; 
  • clarify treatment intentions and minimize confusion regarding a person's treatment preferences;
  • reduce repetitive activities in complying with the Patient Self Determination Act; and
  • facilitate appropriate treatment by emergency medicine and EMS personnel.

The POLST is not intended to replace an advance health care directive document or other medical orders. To the contrary, the POLST process works best when the person has appointed a health care agent to speak for him or her if he or she becomes unable to speak for himself or herself. A health care agent can only be appointed through an advance health care directive called a health care power of attorney.

For persons with advanced illnesses, the POLST puts the advance directive into action by centralizing information, facilitating record keeping, and ensuring transfer of appropriate information among health care professionals and care settings. Different states have different rules governing emergency medical services (EMS). In Pennsylvania, EMS personnel may honor a POLST only upon receiving an order from a medical command physician, so it is critical to put a POLST in place.

A critical difference between a POLST and a living will is that the POLST is completed and signed by the patient and his or her primary care health care provider during a face-to-face meeting; it is not a document that an attorney can complete with or for the client.

Thus, if, or when, you or a loved one has an advanced illness, in addition to working with your attorney to assure there is a current heath care directive in place, be sure to have the patient meet with his or her health care provider to discuss and complete a POLST. 

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