A Physician Orders for Life Sustaining Treatment (POLST) is a document created between the physician and the patient regarding the treatments and care that the patient does and does not wish to receive. A POLST is created based on the patient’s current health. The document considers the progression of the patient’s illness. Based on the prognosis, the patient and doctor will decide which treatments he or she wants to receive based on personal preferences or religious belie

Is POLST Different from an Advanced Directive?

An Advanced Directive is a document used to appoint a health care representative and to guide decisions for future life-sustaining treatment. An Advanced Directive is often used ahead of any serious illness. A POLST form can supplement the Advanced Directive as it guides decisions for current care and treatment of the patient. The following list represents many of the significant differences between the two:

  • Age of Patient: POLST forms apply to patients of all ages, while Advanced Directives apply to individuals over 18 years of age.
  • Emergency Care: POLST will apply in the case of treatment by emergency treatment, while an Advanced Directive will not.
  • Appointment of an Agent: Advanced Directives will appoint an agent to make treatment decisions based on your wishes if you are not capable of doing so. POLST does not appoint an agent, but can be created by your agent in consultation with a physician.
  • Type of Treatment: Advanced Directives generally provide guidance for life-sustaining care generally, while a POLST form covers more specific treatments that may be used. For example, a POLST might provide that the patient does not wish to receive antibiotics, while an Advanced Directive would not cover this.

Additionally, Do Not Resuscitate (DNR) orders generally cover a patient’s wishes to die naturally rather than be administered CPR or other treatments if they stop breathing or their heart stops. POLST may also cover such treatments, but can also cover many other methods of treatment as it has a much broader scope. POLST is sometimes used in place of a DNR order.

Who Benefits from POLST?

The goal of POLST is to provide instructions for care and treatment based on a patient’s current medical condition. As such, its use is recommended for individuals whose death would not be unexpected if it occurred within one year. It is often used for the terminally ill or elderly who are receiving end-of-life care. Without a POLST form, health care providers are required to perform all treatments necessary to sustain the individual’s life.

Will Doctors Respect My Treatment Preferences?

A POLST form often outlines the patient’s wishes for treatment on a brightly colored paper. The instructions for care must be obeyed by emergency personnel, including paramedics and emergency medical technicians (EMTs). Additionally, any care provided following the emergency must also comport with the POLST.

How Do I Create a POLST Form?

When you are admitted to a health care facility, you may be asked whether you wish to complete a POLST. You can also request one as long as your state recognizes POLST. Your physician or another health care professional will consult with you or your appointed agent regarding your wishes and goals for treatment based on your current prognosis. Together, you will determine which treatments comport with your wishes.

The availability of POLST depends on your state. Most states now have a POLST program, although it may go by a different name. Other common names include:

  • Physician Orders for Scope of Treatment (POST)
  • Medical Orders for Life-Sustaining Treatment (MOLST)
  • Transportable Physician Orders for Patient Preferences (TPOPP)
  • A list of programs by state is available through the National POLST Paradigm.

Do I Need an Attorney to Create a POLST?

A POLST form is created between you or your agent and your physician. However, if you have additional questions about planning for your wishes for medical treatment currently or in the future, you might consider discussing the variety of options with a personal injury attorney. Additionally, if your state does not have a POLST program, an attorney can help you create a living will, a durable power of attorney, or a DNR order.