The National POLST Paradigm is an approach to end-of-life planning that emphasizes patients’ wishes about the medical treatments they receive. The POLST Paradigm – which stands for Physician Orders for Life Sustaining Treatment – emphasizes: (i) advance care planning conversations between patients, health care professionals and loved ones; (ii) informed shared decision-making between a patient and his/her health care professional about the treatment the patient would like to receive at the end of his/her life; and (iii) ensuring patient treatment wishes are honored. The decisions from these conversations may be documented as actionable medical orders on a POLST form. A POLST form is a tool that helps ensure patient treatment wishes are known and will be followed by health care professionals during a medical crisis, when the patient cannot speak for him/herself.
A POLST form is not for everyone. The POLST Paradigm is intended for patients with serious illness or frailty, for whom a health care professional would not be surprised if they died within one year, should have a POLST form. For these patients, their current health status indicates the need for standing medical orders. For healthy patients, an advance directive is an appropriate tool for making future end-of-life care wishes known to loved ones.