We are pleased that Hickman et al,
1
some of whom have done much of the heavy-lifting throughout the development of the
Physician Orders for Life-Sustaining Treatment (POLST) program, offered their appraisal
of our MOELI.
2
They question the value or feasibility of 7 of our 16 suggested changes; we hope
that their silence on the remaining 9 means that they either agree with our suggestions,
or at least see no major problems with their implementation. We are surprised by the
tone of some of their objections, because all of our recommendations are consistent
with the policies and guidelines of the National POLST Paradigm Task force (NPPTF)
documents, and many of our suggestions directly implement its prescriptions. We are
fully committed to the paradigm as a way to protect patient autonomy in making decisions
about end-of-life (EOL) care, and we believe that the MOELI does a better job of doing
so than any of the protocols currently endorsed by the NPPTF.To read this article in full you will need to make a payment
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References
- Proposed POLST replacement creates more problems than it solves.J Am Med Dir Assoc. 2017; 18: 1092-1093
- Standardizing protection of patients’ rights from POLST to MOELI (Medical Orders for End-of-Life Intervention).J Am Med Dir Assoc. 2017; 18: 741-745
- POLST Program legislative comparison chart, 2016.(Available at:)http://polst.org/wp-content/uploads/2016/09/2016.08-POLST-Legislative-Comparison-Chart.pdfDate accessed: November 28, 2017
- Patient FAQs.(Available at:)http://polst.org/faq/Date accessed: December 1, 2017
- Fundamental policy principles (2017).(Available at:)http://polst.org/wp-content/uploads/2017/04/2017.02.10-National-POLST-Paradigm-Fundamental-Policy-Priniciples.pdfDate accessed: November 28, 2017
- National POLST Paradigm Task Force supports nurse practitioners and physician assistants signing POLST forms.(Available at:)
- Top ten myths and facts about health care advance directives.Bifocal. 2015; 37: 6-9
- The POLST (Physician Orders for Life-Sustaining Treatment) paradigm to improve end-of-life care: Potential state legal barriers to implementation.J Law Med Ethics. 2008; 36: 119-140
- POLST paradigm fundamentals.(Available at:)http://polst.org/wp-content/uploads/2016/09/POLST-Paradigm-Fundamentals.pdfDate accessed: December 1, 2017
- Application for endorsed POLST paradigm program status.(Available at:)http://polst.org/wp-content/uploads/2017/10/2015.07.23-Application-for-Endorsed-POLST-Paradigm-Program-Status.pdfDate accessed: November 28, 2017
- POLST: Advance care planning for the seriously ill.(Available at:)http://www.polst.org/wp-content/uploads/2015/01/2013.09.26-Final-POLST-Article.pdfDate accessed: December 1, 2017
- 6 Steps Living Will.(Available at:)http://www6stepslivingwill.orgDate accessed: November 15, 2017
- Protocol for the assessment of patient capacity to make end-of-life treatment decisions.J Am Med Dir Assoc. 2018; (in press)
- High physician concern about malpractice risk predicts more aggressive diagnostic testing in office-based practice.Health Aff (Millwood). 2013; 32: 1383-1391
- Overtreatment in the United States.PLoS One. 2017; 12: e0181970
- Use of the Physician Orders for Life-Sustaining Treatment program in the clinical setting: A systematic review of the literature.J Am Geriatr Soc. 2015; 63: 341-350
- Myths and facts about health care advance directives.Bifocal. 2015; 37 (Available at: https://www.americanbar.org/publications/bifocal/vol_37/issue_1_october2015/myths_and_facts_advance_directives.html. Accessed December 27, 2017): 6-9
Article info
Publication history
Published online: January 09, 2018
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© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
