Legislation 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.
“Use 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 a press release.
“The 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 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 POLST Legislation?
SB 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.