Study finds possible legal barriers to national implementation of end-of-life program

MORGANTOWN, W.Va. – Potential legal barriers could stand in the way of more states implementing the Physician Orders for Life-Sustaining Treatment (POLST) Paradigm. That’s according to a study recently published by West Virginia University researchers.

The POLST 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. Its goal is to ensure that patients’ treatment wishes are known and respected.

The POLST Paradigm has been recognized as a best practice in palliative care by the National Quality Forum.  Palliative care is the relief of pain, symptoms and stress of serious illness, with a goal of improving quality of life for patients.

The study, co-authored by Alvin Moss, M.D., director for the WVU Center of Health Ethics and Law, and research assistant Jessica Wehrle Nester, J.D., “The POLST Paradigm to Improve End-of-Life Care: Potential State Legal Barriers to Implementation,” includes a review of all state laws relevant to the POLST Paradigm program.

The study suggests that potential legal barriers include the requirements for out-of-hospital do-not-resuscitate orders, limitation on the authority to consent to forgo life-sustaining treatments, preconditions for use, and witnessing requirements.

West Virginia – where the program is called POST (Physician Orders for Scope of Treatment) – is one of only four states to utilize the program statewide. Other states include Oregon, Utah and Washington. Three states – New York, Pennsylvania and Wisconsin – had regional POLST Paradigm programs in place at the time of the survey.

The study was also completed by Susan Hickman, Ph.D., of the School of Nursing at Oregon Health and Sciences University, and Charles Sabatino, J.D., director of the American Bar Association Commission on Law and Aging. It appears in the spring 2008 issue of the Journal of Law, Medicine, and Ethics.

For more information on end-of-life care including the POST program, call the West Virginia Center for End-of-Life Care at (877) 209-8086 or visit www.wvendoflife.org.

- WVU -

For more information:
Amy Johns, HSC News Service, (304) 293-7087
asj: 04-21-08

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