The Washington State POLST (physician orders for life- sustaining treatment) program was developed during the early 1990s in an effort to honor patients’ end-of-life treatment plans, specifically, to prevent emergency medicine technicians and emergency room personnel from administering excessive, harmful emergency medical treatment. Consequently, unlike advance directives and living wills, a POLST provides legal authority for emergency medical personnel not to initiate CPR (cardiopulmonary resuscitation). POLST documents are designed to be universal and portable, regardless of the particular health care setting, and their directives must be followed as standing physician orders. Since then, the department, in conjunction with the state medical association, composed the POLST in use today. However, these two bodies extended the legislature’s intent beyond defining patient wishes for resuscitation during emergency medical treatment. Had the document remained limited to the legislature’s original, narrow focus, many of the problems we now encounter with POLST would not occur.
Experiences of pre-hospital emergency medical personnel in ethical decision-making: a qualitative study