Advance healthcare directives (living wills), Physician Orders for Life Sustaining Treatment (POLST) documents, and durable power of attorney documents for healthcare are important documents for all individuals to consider and implement. An increasingly common and challenging scenario in healthcare is physical and / or mental incapacity as a consequence of senescence, injury, or pathology. In the absence of these documents, it may be impossible to honor an individual’s wishes for the provision of medical care once he or she is no longer able to express his or her wishes. This frequently results in provision of medical care inconsistent with the patient’s desires, provision of futile and expensive medical care at the end of life, prolongation of suffering, difficult decision making for next of kin tasked with speaking and deciding care on behalf of the patient, conflicts between next of kin regarding direction of medical care, and / or the appointment of an individual to speak and decide care on behalf of the patient that would not have been chosen by the patient (e.g., a court appointed guardian or as directed by state law).
An advance healthcare directive is a legal document that codifies an individual’s desires for life sustaining therapies. In the event of incapacity, this document conveys the individual’s wishes regarding medical care to their healthcare providers. Notably, most states disregard advance healthcare directives in the event of pregnancy.
A POLST document is a standardized medical order completed and signed by a patient, or agent acting on behalf of a patient, in conjunction with a healthcare provider. A POLST specifies treatment orders regarding cardiopulmonary resuscitation attempts (e.g., attempt resuscitation or do not attempt resuscitate) and goals of medical treatments (e.g., full treatments, selective treatments, or comfort-focused treatments). Additionally, orders regarding medically assisted nutrition and / or other treatments (e.g., administration of blood products or initiation of hemodialysis) may be specified. For additional information, please visit POLST.org.
A durable power of attorney for healthcare is a legal document appointing an agent to make decisions regarding medical care on behalf of a principal in the event of the principal’s incapacity. Not all medical decisions and scenarios can be codified in advance; thus, a durable power of attorney for healthcare is important in conjunction with an advance healthcare directive.
These documents are important healthcare directives that work in concert to maximize the likelihood that an individual will receive medical care in accordance with their desires in the event of incapacity.