What is a Physician Orders for Life-Sustaining Treatment (POLST)?

The Physician Orders for Life-Sustaining Treatment (POLST) is a form intended for any individual with a serious health condition. The form provides a way to summarize your wishes regarding life-sustaining treatment. Together, you and your physician discuss and develop a specific plan that reflects YOUR treatment wishes. This plan is translated into a set of physician orders for medical treatment and documented on the POLST form. Your physician signs the form and assumes full responsibility for its accuracy.

The POLST form is portable and is intended to go with you from one care setting to another. The form reduces the need for repetitive end-of-life discussions and provides security for both you and your physician that your expressed wishes will be carried out. Having a completed POLST form can assist physicians, nurses, health care facilities and emergency medical personnel in honoring your treatment wishes.

The POLST form translates your wishes as expressed in your Health Care Directive and Durable Power of Attorney for Health Care into clear and specific medical orders that includes the following:

• Your preferences for resuscitation.
• Medical interventions.
• The use of antibiotics.
• Artificially administered fluids and nutrition.

Obtain a POLST Form

POLST forms can be obtained at your physician’s office. If your physician is not yet aware of the form, your physician should call the WA State Medical Association at (206) 441-9762 or (800) 552-0612 for more information.

For more information visit the Washington State Medical Association website or the Washington State Department of Health, Office of Emergency Medical Services and Trauma System website.