that would create a legal framework for Pennsylvania Orders for Life Sustaining
Treatment (POLST) directives –Senate Bill (SB) 623, introduced by Sen. Gene Yaw
– was unanimously approved by the Senate Health and Human Services Committee on
Dec. 12, 2017.
of a POLST form gives seriously ill patients more control over their treatment
and also helps them talk with their doctors and family members about their
end-of-life choices,” said Sen. Yaw in this press
health and well-being of our patients has always been, and will forever remain,
our number one priority. The care and comfort of our patients is a
responsibility we take very seriously,” said Pennsylvania Medical Society (PAMED)
President Theodore Christopher, MD. “That’s why PAMED is pleased to learn that
SB 623 – POLST legislation that would allow patients to freely direct and
control their end-of-life care – successfully moved out of the Senate Health
and Human Services Committee.”
The latest action on SB 623 is
another step forward in a multi-year, collaborative effort that drew on the
expertise of 27 health care and patient advocacy organizations.
What Is POLST?
The POLST process was created to translate a patient's specific goals for
end-of-life care into a concise medical order that can follow the patient
across all care settings. POLST directives are entirely voluntarily and often
developed through communication between a patient, their caregiver, and their
physician following a terminal diagnosis. Directives typically include
specifications about out-of-hospital do-not-resuscitate preferences, use of
antibiotics, certain comfort measures, and other end-of-life
Without these clear directions
insuring the patient's wishes are followed and the level of care desired by the
patient is delivered – healthcare providers may be left with conflicting
directions. POLST helps to eliminate that confusion.
How Does POLST Differ from Advance
POLST orders differ from advance directives in that POLST directives make clear
an individual's wishes regarding treatment measures via a legal medical order
that is applicable across all health care settings – applicable in emergency
medical services, health care facilities, home care and hospice settings.
Advance directives often only identify a surrogate health care decision-maker
and lack specificity regarding a patient's end-of-life treatment preferences.
Although POLST forms are currently
available in Pennsylvania, these forms presently are not recognized by
Pennsylvania law. House Bill 1196 will codify these orders and require that
physicians, nurses, emergency medical technicians, and other medical
professionals deliver care consistent with a patient's end-of-life preferences.
What's Next for POLST Legislation?
623 now advances to the full Pa. Senate for consideration. A similar POLST bill – House Bill
1196 – has been introduced by House Majority Whip Bryan Cutler and has been
referred to the House Health Committee for consideration.
POLST is among PAMED's current advocacy
priorities. You can find the latest on all our advocacy priorities at www.pamedsoc.org/advocacy.