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How POLST Helps Physicians, Patients with End-of-Life Care Decisions

Pennsylvania Rep. Bryan Cutler (R-100th District) knows firsthand how important it is to honor a patient's preferences for end-of-life care. That's why he and Senator Gene Yaw (R-23rd District) plan to introduce legislation that seeks to provide a framework and legal authority for Pennsylvania Orders for Life-Sustaining Treatment (POLST).

"Like many things that we deal with in the legislature, I think it's fair to say that oftentimes these kinds of issues are colored by our own experiences," said Rep. Cutler. "For me personally, it was both of my parents being terminally ill at a young age."

Rep. Cutler introduced HB 1196 on Sept. 6, 2017. It is currently in the House Judiciary Committee.

Rep. Cutler and Sen. Yaw discuss potential legislation during an event at the Capitol on April 18, 2017. Representatives from several of the stakeholder groups involved in drafting the legislation, including the Pennsylvania Medical Society (PAMED), were also on hand.

A POLST is one or more medical orders, issued for the care of an individual, regarding cardiopulmonary resuscitation or other medical interventions. It would be appropriate for individuals with serious illnesses or frailty when their health care practitioner would not be surprised if they died within the next year.

POLST is voluntary and differs from advance health care directives in that it makes clear an individual's wishes regarding treatment measures via a POLST form, which includes one or more medical orders that are applicable across all health care settings—thereby applicable in emergency medical services, health care facilities, and home care and hospice settings.

Alexander Nesbitt, MD, a PAMED member and palliative medicine physician from Williamsport, Pa., spoke at the event and shared his perspective as a doctor who is involved every day in caring for people who are seriously ill. "It becomes an actionable way for us to know what is the right thing for us to do for this person," he said of POLST.

"We need legislation, we need law in Pennsylvania to ensure that, across the commonwealth, people have access to this tool, and that it's used in the right way," said Dr. Nesbitt.

PAMED supports the POLST legislation and thanks Sen. Gene Yaw and Rep. Bryan Cutler for their willingness to take on the issue. "Many of us want peace of mind during our final days on this earth. Not only is it good for patients, but also for families caring for loved ones who are near the end of life," said PAMED President Charles Cutler, MD, MACP, in a statement.

More Resources

Sen. Yaw offers a video of the April 18 POLST news conference on his website here.

PAMED also offers the following resources:

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