In the mid 1990s, the State of Oregon took the concept of a Do Not Resuscitate, or DNR order one step further and began using a two page form known as a “Physician Orders for Life-Sustaining Treatment”, or POLST for short. DNR orders had been used for decades to allow an individual to make the choice ahead of time that he or she does not want CPR to be administered if he or she is not breathing or is in cardiac arrest. Oregon’s POLST form offers the prospective patient the ability to make more choices than a DNR order, yet falls short of an advanced directive, or living will, since a POLST does not appoint a proxy who can make decisions on behalf of the patient when the patient is unable to do so.
Although a POLST form does allow a choice to be made regarding CPR, it also allows the person to make critical decisions regarding two other important areas of treatment as well — Medical Interventions and Artificially Administered Nutrition. The individual executing the form has the option to select a response in each section. In the Medical Interventions section, for example, the individual may choose either “Comfort Measures Only”, “Limited Additional Interventions” or “Full Treatment”. The option you choose in each section is then a legally binding choice that a physician must abide by if a decision is required regarding the treatment covered in the section.
The popularity of the POLST form is an indication of how important choice is to Americans. Not only has the Oregon POLST system now computerized, making a POLST form accessible to any physician at any hospital, but a number of other states have also adopted the use of the POLST form, or one similar.
The Law Offices of Barton P. Levine is a member of the American Academy of Estate Planning Attorneys.