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Do You Believe Your POLST is Your End-of-Life Superman or is It Your Kryptonite?

Introduction

A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order that specifies an individual's treatment preferences in an emergency situation, whereas an Advance Health Care Directive (AHCD) outlines an individual's wishes for medical treatment if they become unable to make decisions and they can be activated outside of end-of-Life health care. While both are important, a POLST is more specific and actionable in emergency situations.


A POLST (Physician Orders for Life-Sustaining Treatment) and an Advance Health Care Directive (AHCD) are two legally binding documents that pertain to healthcare decisions initiated throughout your life. However, they serve different purposes and cover different aspects of end-of-life care. The primary difference between a POLST and an Advance Health Care Directive lies in the timing and level of specificity.


While an Advance Health Care Directive outlines a person's wishes for future healthcarevin various situations, a POLST is a more specific, actionable document that contains medical orders determined in consultation with a healthcare provider. Both documents play vital roles in ensuring that an individual's healthcare preferences are respected, but they have distinct differences that warrant understanding. It is crucial not to confuse or conflate the two.

Here's a breakdown of their differences:

1. Purpose: An AHCD is a legal document that outlines your healthcare decisions and preferences in the event you become unable to communicate or make decisions. It covers a broader range of healthcare decisions, including medical treatments, life-sustaining interventions, and end-of-life care. While a POLST is a set of medical orders specifically for end-of-life health care in a specific organization, hospital or other health care facility.

2. Legal status: An AHCD is a legally binding document, recognized in most jurisdictions. It allows you to appoint a healthcare proxy or make specific instructions about your medical care, based on the law where you live. POLST, on the other hand, is a medical order reflecting your current medical condition and preferences. It translates your treatment preferences in a specific setting.

3. Scope: While an AHCD covers a wide range of medical decisions over the course of your life, a POLST specifically focuses on medical interventions, resuscitation orders, and life-sustaining treatments. The POLST is generally used for individuals with serious, advanced illnesses or nearing the end of their lives.

4. Execution: An AHCD is usually completed outside of a medical facility, often in consultation with an attorney, and requires appropriate witnesses or notarization as per local laws. A POLST, on the other hand, is typically completed inside a specific healthcare facility in collaboration with a healthcare provider, reflecting their medical recommendations based on your current health status and goals of care.


Conclusion

An Advance Health Care Directive and a POLST are both important legal documents that address end-of-life care. However, there are key differences between the two. A POLST is a specific, actionable document that contains medical orders agreed upon with a healthcare provider, whereas an Advance Health Care Directive outlines broad healthcare wishes for various situations.


Both documents serve to ensure that an individual's healthcare preferences are respected, but they approach this goal in different ways. It is important to understand the distinctions between a POLST and an Advance Health Care Directive to make informed decisions about end-of-life health care. It is beneficial to have both an Advance Health Care Directive and a POLST when appropriate since they complement each other in conveying your wishes.


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