The POLST paradigm and form:Facts and analysis

Christian Brugger; Louis C Breschi; Edith Mary Hart; Mark Kummer; John I Lane; Peter T Morrow; Franklin L Smith; William L Toffler; Marisa Beffel; John F Brehany; Sara Buscher; Rita L Marker

doi:10.1179/0024363913Z.00000000027

The POLST paradigm and form:Facts and analysis

Linacre Q. 2013 May;80(2):103-38. doi: 10.1179/0024363913Z.00000000027.

Authors

Affiliations

¹ St. John Vianney Theological Seminary Denver, CO, USA.
² Franklin Square Medical Center, Baltimore, MD, USA.
³ Sacred Heart Mercy Health Care Center, Jackson, MN, USA.
⁴ Nemours Children's Clinic and Florida State University School of Medicine, Pensacola, FL, USA.
⁵ Mayo Clinic, Rochester, MN, USA.
⁶ St. Cloud Regional Medical Center, St. Cloud, FL, USA.
⁷ Aurora Summit Hospital, Summit, WI, USA.
⁸ Oregon Health & Science University, Portland, OR, USA.
⁹ Brookfield, WI.
¹⁰ Ethicist of the Catholic Medical Association, Bala Cynwyd, PA, USA.
¹¹ Appleton, WI.
¹² Patients Rights Council, Steubenville, OH, USA.

Abstract

This white paper, prepared by a working group of the Catholic Medical Association, provides a commentary on a new type of end-of-life document called a POLST form (Physician Orders for Life-Sustaining Treatment) as well as on its model (or "paradigm") for implementation across the United States. After an introductory section reviewing the origin, goals, and standard defenses of the POLST paradigm and form, the paper offers a critical analysis of POLST, including an analysis of the risks that POLST poses to sound clinical and ethical decision-making. The paper ends with several recommendations to help Catholic healthcare professionals and institutions better address the challenges of end-of-life care with alternatives to POLST.

Keywords: Advance decision-making; Advance directive; Catholic health care; End of life care; Euthanasia; In-the-moment-of-need medical decision-making; Living will; POLST.