In 1991 leading medical ethicists in Oregon discovered that patient preferences for end-of-life care were not consistently honored. Recognizing that advance directives were inadequate for the patients with serious illness or frailty — who frequently require emergency medical care — a group of stakeholders developed a new tool for honoring patients’ wishes for end-of-life treatment. After several years of evaluation, the program became known as Physician Orders for Life-Sustaining Treatment (POLST).
In September 2004 the National POLST Advisory Panel, later known as the National POLST Paradigm Task Force, convened to establish quality standards for POLST forms and programs and to assist states in developing the POLST Paradigm. At that time only six states had POLST programs: New York, Oregon, Pennsylvania, Washington, West Virginia and Wisconsin. Leaders from those states, some of whom had been developing their POLST programs in their respective states for almost 10 years, served as original members along with several consultants who advised on topics critical to the development of the POLST Paradigm. Many of our founding members still serve on the Task Force today.
Original Task Force members:
- Chair: Patrick (Pat) Dunn, MD, Legacy Health Systems (Oregon)
- Patricia (Pat) Bomba, MD, Excellus BlueCross BlueShield (New York)
- Judith (Judy) Black, MD, Highmark Blue Cross Blue Shield (Pennsylvania)
- Sally Denton (Washington)
- Bernard (Bud) Hammes, PhD, Gundersen Lutheran Health System (Wisconsin)
- Alvin (Woody) Moss, MD, West Virginia University (West Virginia)
- James (Jim) Shaw, MD, Providence Health (Washington)
- Susan Tolle, MD, Oregon Health & Science University (Oregon)
- Margaret (Margie) Carley, JD (Long-term Care)
- Malene Davis, MBA, MSN (Hospice)
- Susan Hickman, PhD (Research)
- Charlie Sabatino, JD (Legal)
- Terri Schmidt, MD (EMS and Emergency Medicine)
The National POLST Paradigm Task Force was replaced with a new governance structure in 2018. We appreciate and thank all the individuals who served on the Task Force. The national organization is called the National POLST Paradigm and POLST is defined as a “portable medical order” (we no longer use the acronym).
The National POLST Paradigm Office supports the activities of the National POLST Paradigm and serves as a resource to all POLST programs. Originally housed at the Oregon Health & Science University (OHSU) Center for Ethics in Health Care, the National Office left OHSU in January 2017. The National POLST Paradigm is a project of Tides and based in Washington DC.