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Practitioner Orders for Life Sustaining Treatment (POLST)

A Practitioner Orders for Life-Sustaining Treatment, more commonly referred to as a POLST, is a health care planning tool that allows individuals to work closely with their doctors and advance practice nurses to set forth the patient's personal goals and medical preferences when facing a serious illness. Gov. Chris Christie signed New Jersey's POLST law in December 2011, and it's now being introduced across the state to help patients and their families with end-of-life care planning.

The new POLST form is designed to be completed jointly by the patient and a physician or advance practice nurse, expressing the patient's goals of care and medical preferences. Unlike an Advance Directive for Heath Care (Living Will), a completed POLST form is an actual medical order that becomes a part of the individual's medical record. The POLST is valid in all health care settings and is transferred from one health care facility to another. This process makes patients and their medical professionals partners in ensuring the patient's wishes are expressed and respected. That is the intent of POLST.

How is a POLST different from a Living Will? The POLST does not replace the Living Will and a Living Will does not replace a POLST. Rather, the two documents complement each other. You may still need a POLST even if you have a Living Will. A Living Will is usually prepared when you are still relatively healthy and want to express your desires as to life sustaining treatment in the event that, at some point in the future, you are unable to make such decisions. In addition, in your Living Will, you can appoint someone to make decisions regarding your healthcare in the event that you cannot. Because, in most cases, you may not be aware of all of the health care options available to you at the time you prepare your Living Will, by nature, your Living Will cannot be specific as to what procedures you would want your health care professionals to take.

On the other hand, in most cases, a POLST would be prepared by your health care professionals at a time when you are in an end-of life condition. In those cases, your health care professionals will be better able to discuss your medical condition and what procedures may be available to you. This will allow you to decide what procedures you would want taken. The POLST would then be prepared by your health care professionals and signed by you to make sure that your desires are followed.

The New Jersey POLST law also allows the heath care representative appointed in your Living Will to make end-of life decisions and to sign the POLST form on your behalf in the event that you are not competent to make the POLST decision.

Everyone should have a Living Will. Whether you need a POLST or not is a matter which you should discuss with your healthcare professionals.