It’s always wise to include an advance health care directive in your estate plan. In fact, adults of any age can benefit from having one even if they don’t yet have a will or other estate planning documents.
An advance directive allows you to codify your wishes if you are unable to speak for yourself. Typically, people use this document to designate what measures they do and don’t want taken to prolong their life. You can also list criteria for discontinuation of life support under various circumstances.
In conjunction with an advance health care directive, people typically designate someone (typically known as an “agent”) to have power of attorney (POA) for their health care. That person is allowed to make health care decisions on your behalf but following your wishes as designated in your advance directive.
This directive, however, is not considered a medical order. Doctors aren’t required by law to follow it if they feel it violates their oath or the wishes aren’t medically appropriate.
When is a POLST warranted?
A POLST, which is commonly referred to as a “portable medical order,” is something that people draw up to designate their treatment wishes when they’re facing a “life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty.”
Maybe a person is about to have complex brain surgery. It may be the only chance at saving their life, but it could leave them in a life-long vegetative state. This would be a time to consider a POLST – particularly if they don’t have an advance directive or they don’t feel their directive adequately addresses the possibilities they’re now facing. If they have an advance directive, that’s often the starting point for a POLST.
A POLST is something that’s discussed and drawn up by a patient and their doctor based on a specific situation. An advance health care directive, which should be drawn up with experienced legal guidance, is intended to be available should the unexpected happen, like a serious car crash, that leaves a person unable to communicate their wishes. Don’t assume that you don’t need an advance directive because you can always draw up a POLST. You may be in no condition to do that.