Volume 23, Number 4, Winter 2012

Legal Briefing: POLST: Physician Orders for Life-Sustaining Treatment

Thaddeus Mason Pope and Melinda Hexum

The Journal of Clinical Ethics 23, no. 4 (Winter 2012): 353-76.


This issue’s “Legal Briefing” column covers recent legal developments involving POLST (physician orders for life-sustaining treatment.) POLST has been the subject of recent articles in JCE. It has been the subject of major policy reports and a recent New York Times editorial. And POLST has been the subject of significant legislative, regulatory, and policy attention over the past several months. These developments and a survey of the current landscape are usefully grouped into the following 14 categories:

1.   Terminology

2.   Purpose, function, and success

3.   Status in the states

4.   Four legal routes of implementation

5.   Which professionals can authorize POLST?

6.   Is the patient’s signature required?

7.   Can surrogates consent to for incapacitated patients?

8.   If a POLST conflicts with an advance directive, which prevails?

9.   Is offering POLST mandatory?

10.  What are the duties of healthcare providers?

11.  What is the role of electronic registries?

12.  What is the role of the federal government?

13.  International adoption

14.  Court cases

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