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p h i l a m e d s o c  .org

Feature

What does a POLST form
mean to you and your patients?
By: Herbert Patrick, M.D., M.S.E.E., and Peter A. Clark, S.J., Ph.D.

"Only one man can tell when it's your time,
but he doesn't send you a letter."
-William Norton, end stage disease patient, 2017

D

o you have an advance directive? Have you What is a POLST form?
discussed advance directives with your patients?
A Pennsylvania Orders for Life-Sustaining Treatments (POLST)
The Pennsylvania Orders for Life-Sustaining form is a medical order that gives patients more control over their
Treatments (POLST) form is an easy to understand end-of-life care. The POLST form specifies the types of medical
supplement to an advance directive, and can substitute treatment that a patient wishes to receive towards the end of life.
when no advance directive has been written. Ideally, each These medical orders are signed by either a patient's physician,
physician assistant or nurse practitioner and the patient or the
patient who is ill and likely to develop end-stage disease patient's surrogate.
within 6-12 months should arrive in admissions with
Completion of a POLST form is only a small step in the process
their advance directive and/or POLST completed. The
of a patient's decision-making, and it is critical that this form be
advance directive and/or POLST should be completed used as part of a program for end-of-life decisions that includes
prior to admission in discussion with their primary care educational support and other aspects of planning for providers and
patients. This form was developed by the Pennsylvania Department
physician. Not every state has a POLST program.
Recall that there are two types of advance directives
in Pennsylvania (Table 1): a living will and a document
naming a health care agent.

of Health's Patient Life-Sustaining Wishes Committee and designed
to be consistent with Pennsylvania law.

There are significant advantages to using a form that contains
standardized language and is produced in a distinctive and easily
recognizable format.
Continued on page 20

18 Philadelphia Medicine : Spring 2018



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