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An Advanced Directive is not a medical order and this is the problem that POLST can solve.  Amy Vandenbroucke, JD is the executive director of the National POLST Paradigm, an organization that seeks to educate us on our end-of-life choices and how to make sure they will be followed.

Death and Dying are not easy topics to discuss, but doing so ahead of time and making informed decisions about how we and our loved ones want to be treated can save everyone a lot of pain and heartache.  Even with an Advanced Directive, Power of Attorney, or Surrogate, emergency medical personal are required by law to treat a victim who doesn’t possess a DNR.  POLST is a portable medical order that EMS can follow.

POLST stands for Physician Orders for Life-Sustaining Treatment.  Unlike an Advanced Directive or Living Will, POLST is a medical order that allows an individual to choose, ahead of time, whether or not to receive CPR, Limited Treatment, or Full Treatment in the event of a life threatening or debilitating illness or accident.  POLST helps individuals die where and when they want to die.

In Oregon and many, but not all, other states, a POLST can be obtained from your personal doctor.  It is included in the annual visit protocol for Medicare recipients and consists of a discussion of one’s diagnosis, prognosis, available treatment options and outcomes, personal goals and values.  It is always voluntary, changeable, and revocable.  It is not a cost saving measure, although Ms. Vandenbroucke pointed out that medical bills are the number one reason for bankruptcy in the U.S.

Amy Vandenbroucke loves the intersection of health law and ethics. She served as Legal Counsel for Oregon Health & Science University for 6 years before becoming an Associate Director at the OHSU Center for Ethics in Health Care. There she served as Chair of the Oregon POLST Task Force for 2 years and the Executive Director of the National POLST Paradigm for 4 years.  She recently moved the National POLST Paradigm to Washington DC and continues her work at the national level.  Having her own experience in losing her mother, she is passionate about helping make end of life easier for patients and families, helping with those hard conversations, and ensuring treatment preferences are elicited, documented and honored.