What is a POLST?

As medical technology has advanced over the years we have seen both its blessings and its curses. Opinion as to whether life should be sustained regardless of the circumstances varies widely. Due to these differences of opinion, lawmakers have sought to place that choice solely in the hands of those who are best prepared to make those choices: each of us, individually. Although I have previously discussed the Utah Advance Health Care Directive Act as one of the tools to ensure that each of us is heard with respect to the type of medical care we receive, there is another important tool for accomplishing this purpose: a "POLST" or a Physician's Order for Life-sustaining Treatment.

In 2002, the Utah Department of Health implemented rules designed to "provide[] for the orderly communication and transfer of physician orders that outline individual preferences for life-sustaining treatment when an individual transfers from one licensed health care facility to another." The rules also allow paramedics and other emergency medical personnel to follow specific instructions of a patient regarding potential life-sustaining treatment.

What is the difference between an Advance Health Care Directive (AHCD) and a POLST? An AHCD is designed to cover a much broader spectrum of legal, end-of-life decisions such as routine medical care decision-making, admittance to care facilities and hospitals, organ donation, consent to participate in medical research, etc. An AHCD is also designed to make your wishes clear under future, hypothetical medical circumstances. A POLST, while similar is much more limited, and can also be more effective in an emergency situation. A POLST is designed to be easily transferred between medical personnel and institutions as a part of your medical file. It provides instructions concerning the kinds of life-sustaining treatment that you do or do not want administered if you were in an emergency situation today, without requiring consultation with an appointed health-care agent.

It may be difficult to really grasp the differences between the two instruments and I won't attempt to explain them fully here. If you have questions about whether you should execute an AHCD, a POLST or both, talk to an Elder Law attorney and your Physician. Professionals like these can help you more fully understand the nuances of these important health care instruments and how they can ensure that you receive the type of medical treatment that you are most comfortable with given your own unique values and circumstances.