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Physician Orders for Life-Sustaining Treatment (POLST)

 Many readers may have already managed their end of life financial affairs with a recommended Living Trust.  This article is designed to explain some of the details of the State ofCaliforniaapproved form to save your survivors the medical decision-making burden of some of the end of your life details.

The new form, the Physician Orders for Life-Sustaining Treatment (POLST), gives instructions about specific treatments in three sections.  These treatment sections include Cardiopulmonary Resuscitation (CPR), various alternatives of Medical Interventions, and Artificially Administered Nutrition, including feeding tubes.

Across the very top of both sides of the new form appears:  “HIPAA permits disclosure of POLST to other Health Care Providers as necessary.”

The form also directs:  “First follow these orders, then contact physician.  This a Physician Order Sheet based on the person’s current medical condition and wishes.  Any section not completed implies full treatment for that section.  A copy of the signed POLST form is legal and valid.  POLST complements an Advance Directive and is not intended to replace that document.  Everyone shall be treated with dignity and respect.”

The medical portions of POLST should be discussed by the patient and the health care provider, including, on page two, the portion of the Directions for Health Care Provider that under the subheading “Using POLST”.

The new form must be completed and signed by a health care provider based on patient preferences and medical indications.  The patient (or a legally recognized decisionmaker) must also sign the form.

The new form is designed to be used with an Advance Directive to ensure consistency.

Both the Advance Directive and POLST should be reviewed periodically by patient and doctor together.

Both the Advance Directive and POLST should be reviewed when the person is transferred from one care setting or care level to another.

Both the Advance Directive and POLST should be reviewed when there is a substantial change in the person’s health status.

Both the Advance Directive and POLST should be reviewed when the person’s treatment preferences change.

The Emergency Medical Services Authority recommends POLST to be printed and/or copied on 65# Cover Ultra Pink card stock

Copies of POLST should be placed in your medical files and wherever a health care provider might find it when the time comes.  You might consider making the copies visible from near your front door and near your bed and with you in your automobile and other vehicles of travel, like bus, train and airplane.

The California Health and Safety Code beginning at section 1797 authorizes the Emergency Medical Services Authority to coordinate and integrate all state activities concerning emergency medical services.   Physician Orders for Life-Sustaining Treatment (POLST) was effective April 1, 2011 as form #111 B of the Emergency Medical Services Authority.  To download a copy of POLST, go to:  http://capolst.org/wp-content/uploads/2014/08/Final-2014-ENG-CA-POLST-Form.pdf .