A durable power of attorney for healthcare and a living will are both advance directives, that is, directives regarding healthcare decision made in advance of the need to make those decisions—most often regarding decisions at the end of life.
In the first case, the advance directive designates a healthcare proxy to make those healthcare decisions if necessary—and may include written instructions for certain situations.
In the second case, the advance directive does not designate a proxy, but contains written instructions about various healthcare decisions which will likely need to be made.
California law now recognizes in statute the POLST (Physician Orders for Life Sustaining Treatment) form—which complements rather than replaces a standing Advance Healthcare Directive.
The POLST form is voluntary and is intended to be a valuable tool for initiating and guiding the decision-making process between physicians and patients with serious health conditions. It is very useful in assisting doctors, nurses, healthcare facilities and emergency personnel to honor the patient’s wishes—particularly if the patient is moved from one healthcare facility to another (for example, from hospital to nursing home.)
The POLST form, which is a bright pink, considers the patient’s medical condition and allows the patient to determine morally appropriate treatment ranging from comfort measures only to aggressive treatment, including intensive care. The POLST form can guide discussions with physicians in a way which recognizes preserving dignity while dying to be a goal equal to prolonging life.
The POLST form allows checking () choices for Cardiopulmonary Resuscitation (CPR), Medical Interventions and Artificially Administered Nutrition. POLST presumes full treatment unless specified otherwise.
When a patient is not capable of decision-making, POLST provides that a guardian or surrogate may determine treatment that is faithful to the patient’s intentions and values or, if they are unknown, to the patient’s best interests.
Catholic moral teaching on health care nurtures a truly interpersonal patient-physician relationship. The faith that inspires Catholic health care guides medical decisions in ways that support the patient’s stewardship responsibilities and the physician’s professional duties. POLST has proven that it can bolster this relationship and protect the patient’s dignity in reaching decisions about life-sustaining treatment.