In early September 2017, House Majority Whip Bryan Cutler introduced House Bill 1196, a bill concerning Pennsylvania Orders for Life Sustaining Treatment (POLST).
The introduction of this legislation, and with such a highly-regarded sponsor, represents a major step forward for a multi-year, collaborative effort that drew on the expertise of 27 health care and patient advocacy organizations. During a press conference at the Capitol this Spring, Senator Gene Yaw also announced his intention to introduce similar legislation related to POLST in the Senate.
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 considerations.
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 Directives?
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 HB 1196?
After its introduction in the House, the bill was referred to the House Judiciary Committee under Chairman Ron Marsico. Pennsylvania Medical Society (PAMED) lobbyists are in communication with the committee's members and are hopeful that the legislation will be considered before the end of the year.
POLST is among PAMED's advocacy priorities for 2017-2018. You can find the latest on all our advocacy priorities at www.pamedsoc.org/advocacy.