Choosing End-of-Life Care

Make your care choices in advance

A new type of program is making it easier for people to make their own end-of-life health care decisions, removing the stress and pressure from families and loved ones. A recent Wall Street Journal article described these programs, called "Polst":

The programs are known as Physician Orders for Life-Sustaining Treatment, or Polst. They are meant to complement advance directives, sometimes known as living wills, in which people state in broad terms how much medical intervention they will want when their condition no longer allows them to communicate. A Polst, which is signed by both the patient and the doctor, spells out such choices as whether a patient wants to be on a mechanical breathing machine or feeding tube and receive antibiotics.

Polst programs are currently in use in 14 states and regions, including California, Oregon and New York. Three states, Colorado, Idaho and Pennsylvania, adopted Polst programs recently, and another 16 states and six regions are developing programs. Besides providing documents that meet local regulations, the programs train health-care providers to discuss end-of-life treatment choices with patients with terminal illness or anyone wishing to define their care preferences.

Polst forms are recognized as official medical orders, giving them more weight than living wills and protecting medical personnel such as doctors or hospice care workers who might otherwise be held liable for the results of following a patient's orders. Anything that makes it easier to receive the type of end-of-life care that a person desires is good, and a nationwide Polst program could be just the thing we need.