A Physician Order for Life-Sustaining Treatment (POLST) is a document that is designed to allow terminally ill individuals and those experiencing an emergency to indicate to health care professionals what they desire to happen in life-ending situations. A POLST is NOT a substitute for a Health Care Directive. POLST documents are short (often fill-in-the-blank) and limited as to how you are able to express your beliefs surrounding life-sustaining treatments. At its most basic level, a POLST allows you to instruct health care professionals to do everything in their power to keep you alive, or to allow you to die naturally with only specifically authorized care. Often, a POLST form will come into play in emergency room visits and 911 calls.
Within the POLST form, three key end-of-life issues are presented. These include choices surrounding the use of CPR, the level of medical intervention allowable, and the use of artificial nutrition/hydration. A POLST document becomes important when someone encounters a new, serious condition and they do not have a Health Care Directive in place.
To be effective, a POLST must include the signature of a doctor. This is a REQUIREMENT. Without a doctor’s signature, a POLST holds absolutely no power, as it is not technically a medical “order”. The doctor will often fill in the patient’s preferences after having a conversation with the patient. A patient must express an interest in completing a POLST form to the doctor, as neither a doctor nor a patient can create a POLST independently.
Overall, a POLST form is something that controls in terminal and emergency situations. A Health Care Directive is vastly preferred to a POLST form due to its breadth and its ability to be tailored to the individual’s specific wishes and beliefs. Understanding the difference between the powers of these two documents can be crucial to controlling the final stages of one’s life. If you or a loved one is experiencing an irreversible, serious health condition, be sure to ask your doctor about a POLST form or complete your Health Care Directive as soon as possible.
For more information on Minnesota’s specific POLST requirements visit: http://www.mnmed.org/advocacy/improving-health-of-minnesotans/POLST-Communications.