What is AzPOLST?
When you are seriously ill, making sure your loved ones and doctors know what kinds of medical treatment you want as you approach the end of your life is very important. Arizona Provider Orders for Life-Sustaining Treatment (AzPOLST) can help do just that.
AzPOLST is a form that clearly states what kinds of medical treatment patients want toward the end of their lives. Printed on bright pink paper, and signed by both a patient and physician, nurse practitioner or physician assistant, AzPOLST helps give seriously-ill patients more control over their care.
AzPOLST also helps you talk with your healthcare team and your loved ones about your choices. In this way, AzPOLST can help reduce patient and family suffering, and make sure that your wishes are known and honored.
The AzPOLST is not for everyone; the AzPOLST is intended for patients with serious illnesses or frailty for whom their health care professionals would not be surprised if they died within a year. For these patients, their current health status indicates the need for standing medical orders for emergent medical care. For healthy patients, an advance directive is an appropriate tool for making future end-of-life care wishes known to loved ones. Below are some succinct statements clarifying AzPOLST:
Completing an AzPOLST form is always voluntary.
The AzPOLST Form is a medical order, similar to the Prehospital Medical Care Directive (Do Not Resuscitate) order. AzPOLST is not an advance directive. AzPOLST does not substitute for naming a health care agent or durable power of attorney for health care.
The AzPOLST Form is not for everyone. AzPOLST Forms are appropriate for patients with serious illnesses or frailty for whom their health care professionals would not be surprised if they died within a year.
The AzPOLST Form is completed as a result of the process of informed, shared decision-making. During the conversation, the patient discusses his or her values, beliefs, and goals for care, and the health care professional presents the patient’s diagnosis, prognosis, and treatment alternatives, including the benefits and burdens of life-sustaining treatment. Together they reach an informed decision about desired treatment, based on the person’s values, beliefs and goals for care.
The AzPOLST Form allows patients to have their religious values respected. For example, the AzPOLST Form allows Catholics to make decisions consistent with the United States Conference of Catholic Bishops Ethical and Religious Directives for Catholic Health Care Services, 5th ed. (2009) and ensures that those decisions will be honored in an emergency and across care transitions.
The AzPOLST Form enables physicians to order treatments patients would want and to direct that treatment that patients would not want, those they consider “extraordinary” and excessively burdensome, shall not be provided.
The AzPOLST Form requires that “ordinary” measures to improve the patient’s comfort and food and fluid by mouth, as tolerated, are always provided.
The AzPOLST Form is actionable and prevents initiation of unwanted, disproportionately burdensome extraordinary treatment.
State law authorizes certain health care professionals to sign medical orders; the AzPOLST Form is signed by those health care professionals who are accountable for the medical orders.
The AzPOLST form requires health care professionals be trained to conduct shared decision-making discussions with patients and families so that AzPOLST Forms are completed properly.
The AzPOLST form recognizes that allowing natural death to occur is not the same as killing. AzPOLST does not allow for active euthanasia or physician assisted suicide.