Physician Orders for Life-Sustaining Treatment (POLST)

Physician Orders for Life-Sustaining Treatment (POLST), a standardized medical order form printed on brightly colored paper, indicates which types of life-sustaining treatment a seriously ill patient wants or doesn't want if his or her condition worsens. Too often, necessary conversations about end-of-life medical interventions and intensity of care don't occur. The POLST form, signed by both the physician and the patient, becomes a tool to capture these discussions and make them part of the patient's medical record. The form moves with the patient and must be honored across all settings of care. POLST is intended to avoid unwanted or medically ineffective care, reduce patient and family suffering, and ensure that patients' wishes are honored at the end of life.
Since January 2009, California law requires that POLST be honored across all settings of care and provides immunity to providers who honor a POLST document in good faith.
POLST is a vehicle to bring clarity around the difficult decisions for end of life care. When used with an advance directive that names a proxy decisionmaker, it would reduce the initiation of unwanted or medically ineffective care, reduce patient and family suffering, and ensure that patients' wishes are honored at the end of life.