The POLST paradigm: Respecting the wishes of patients and families

Abstract

Despite the hope that traditional advance directives would ensure that patients' end-of-life treatment preferences are honored, numerous studies have found that only 20-30 percent of U.S. adults have an advance directive, and that these documents have limited effect on treatment decisions near the end of life. Some of the limitations associated with traditional advance directives are that they may not be available when needed, are not transferred with the patient, may not be specific enough, may be overridden by a treating physician, and do not immediately translate into a physician order.