title: Physician orders for life-sustaining treatment and emergency medicine: ethical considerations, legal issues, and emerging trends.
abstract: Since its original development in Oregon in 1993, Physician Orders for Life-Sustaining Treatment (POLST) is quickly growing in popularity and prevalence as a method of communicating the end-of-life care preferences for the seriously ill and frail nationwide. Early evidence has suggested significant advantages over advance directives and do-not-resuscitate/do-not-intubate documents both in accuracy and penetration within relevant populations. POLST also may contribute to the quality of end-of-life care administered. Although it was designed to be as clear as possible, unexpected challenges in the interpretation and use of POLST in the emergency department do exist. In this article, we will discuss the history, ethical considerations, legal issues, and emerging trends in the use of POLST documents as they apply to emergency medicine.
authors.affiliation: Christiana Care Health Center, Newark, DE. Electronic address: jjesus@christianacare.org.
authors.forename: John E
authors.initials: JE
authors.lastname: Jesus
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Geiderman
authors.affiliation: Allegheny Health Network, Pittsburgh, PA.
authors.forename: Arvind
authors.initials: A
authors.lastname: Venkat
authors.affiliation: Medical University of South Carolina, Charleston, SC.
authors.forename: Walter E
authors.initials: WE
authors.lastname: Limehouse
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Derse
authors.affiliation: University of Auckland, Auckland, New Zealand.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Larkin
authors.affiliation: Pardee UNC Health Care, Hendersonville, North Carolina.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Henrichs
mesh_terms: D032722:Advance Care Planning / Q000941:ethics / Q000331:legislation & jurisprudence; D004635:Emergency Medicine / Q000941:ethics* / Q000331:legislation & jurisprudence; D004636:Emergency Service, Hospital / Q000941:ethics / Q000331:legislation & jurisprudence; D006801:Humans; D008020:Life Support Care / Q000941:ethics* / Q000331:legislation & jurisprudence; D010820:Physicians / Q000941:ethics* / Q000331:legislation & jurisprudence; D016414:Resuscitation Orders / Q000941:ethics* / Q000331:legislation & jurisprudence; D014481:United States