What Is POLST (Physician Orders for Life-Sustaining Treatment)?

As medical technology has advanced, we have been faced with moral, ethical, and preferential questions regarding life-sustaining treatment. Often, these questions remain unanswered during a person's life, leading to tragic arguments over a person's medical treatment.

There are several legal documents available to try and plan ahead for medical treatment, like living wills and durable powers of attorney. A physician order for life-sustaining treatment, or POLST, also tries to set out a patient's wishes regarding medical treatment should he or she become incapacitated, but also differs from other advance directives.

POLST in General

A POLST, as opposed to many other advance directives, is a binding agreement following a conversation with a doctor. In fact, a POLST must be signed by a physician in order to be valid, while some states will honor those without a patient signature. A POLST is also an order to health care workers regarding a patient's treatment during an emergency; if he or she can't speak or is otherwise incapacitated, medical staff will refer to the POLST before administering treatment.

Although not all states have POLST programs, some states, like California, Illinois, and New Jersey, have extensive online resources regarding POLST initiatives and practices.

The Specifics

While other medical directives can be long documents dealing with a variety of topics, the POLST deals only with cardiopulmonary resuscitation (CPR), medical interventions like intubation, and artificially administered nutrition like feeding tubes. (Here you can see a PDF of California's POLST form.)

Along with specific options for each treatment, the form includes instructions from healthcare providers on how to interpret the form and administer medical care in an emergency. In some states, the forms are bright colors and must be included in your medical record everywhere you go.

A POLST form can supplement an existing advance directive or be your sole directive regarding life-sustaining treatment. While a POLST can always be modified or voided, you should think about your decisions carefully and consult with a trusted physician before completing the form.

You may also want to consult with an experienced health care attorney near you.

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