POLST or POA?

Mourning

In my estates practice, I frequently draft Powers of Attorney for Personal Care (POAs). These allow my clients to plan for potential incapacity, as they name a person who will manage their care if they cannot direct it themselves and often state some generalized instructions about how they want their care to be managed. My clients will often request a clause dealing with end of life care, which generally states, for example, whether they wish to be kept on life support in certain situations.

Last week, I read this article in the Wall Street Journal about Physician Orders for Life-Sustaining Treatment, or POLSTs. A POLST is meant to complement the general advance directives in a POA. It is an agreement signed between patient and doctor, and because it is signed with the doctor it goes into much greater detail about future care, such as whether the patient wants to be placed on a ventilator or feeding tube, or have antibiotics given or withheld. POLSTs are currently accepted in 14 states, with 16 more developing programs; they are not yet regularly used or standardized anywhere in Canada.

Making decisions about the medical care of another person is never easy. If that person has sat down with his or her doctor, had numerous situations explained, and made decisions about his or her care that are clearly documented, those decisions would be vastly easier. As our population ages, I suspect that POLSTs will become both necessary and more common. Expect to see these becoming common in Canada in the not too distant future.

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