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POLST Can Be Dangerous

Anyone who has entered a hospital or health care facility has likely experienced being handed a POLST (Physician Orders for Life Sustaining Treatment) form to fill out. A POLST form is different from an Advance Directive. POLST forms are routinely handed out to patients with the intent that the patient fill them out before receiving care. There is, however, no requirement that a POLST form be filled out!

Filling out a POLST form may actually endanger your life if it’s not filled out correctly and at the appropriate time in a person’s life. A recent example concerns a gentleman, who, as a health care representative for his elderly mother, filled out a POLST for her. Thinking of the worst scenario, a massive heart attack, he checked the “Do Not Resuscitate” (DNR) box, along with “Comfort Measures Only.” Then, his mother fell and hit her head, receiving injuries that were treatable. However, when taken to the hospital, because of the way her POLST form was filled out, she could not be treated.

The POLST form, initially designed to decrease unnecessary health care interventions at the end of life, is being promoted as a tool for decreasing health care costs, but it is not able to accommodate the myriad ways that a patient could need medical attention. It has several limitations:
*It becomes a physician’s order and must be followed.
*It is simplistic and may not reflect current medical circumstances.
*It can easily be misused.
*It is inflexible and, in most cases, overrides any decisions the health care representative/person you have chosen to have power of attorney can make.

Unless you have a prognosis of less than one year to live, Oregon Right to Life discourages filling out a POLST form.

If you decide that a POLST form you have previously fill out is no longer appropriate for you, it can be voided by calling the POLST registry at 503-418-4083. It is important that you also notify your health care professional about the cancellation. If you would like to change the way your form is filled out, please contact your health care professional to make the changes.

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