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 Paradigm Form. A POLST Paradigm 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 Paradigm Form is not for everyone. Only 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 Paradigm 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.