The POLST (Physician Orders for Life-Sustaining Treatment) Paradigm to Improve End-of-Life Care: Potential State Legal Barriers to Implementation.Susan E. Hickman,Charles P. Sabatino,Alvin H. Moss &Jessica Wehrle Nester -2008 -Journal of Law, Medicine and Ethics 36 (1):119-140.detailsThe Physician Orders for Life-Sustaining Treatment Paradigm is designed to improve end-of-life care by converting patients’ treatment preferences into medical orders that are transferable throughout the health care system. It was initially developed in Oregon, but is now implemented in multiple states with many others considering its use. Accordingly, an observational study was conducted in order to identify potential legal barriers to the implementation of a POLST Paradigm. Information was obtained from experts at state emergency medical services and long-term care (...) organizations/agencies in combination with a review of relevant state law. Legal analysis of survey responses and existing laws identified several potential state legal barriers to a POLST Paradigm implementation. The most potentially problematic barriers are detailed statutory specifications for out-of-hospital DNR protocols. Other potential barriers include limitations on the authority to consent to forgo life-sustaining treatments, medical preconditions, and witnessing requirements for out-of-hospital DNR protocols. (shrink)
Should the Incapacitated Patient’s Prior Refusal of Dialysis Be Honored? The Value of a Systematic Approach to Gathering Data in an Ethics Consultation.Alvin H. Moss -2023 -American Journal of Bioethics 23 (8):90-91.detailsIn the early days of ethics consultation, two pioneer consultants noted that one of their important functions was to gather missing information and correct misinformation relevant to the facts of t...