Center to Advance Palliative Care

... ...
For Patients and Families
Partner
Sponsor
 
  Print this page
Views

CAPC Palliative Care Discussion Forum
General Operational Topics

Next Reply: Re:Interface between AD's and POLST
Previous Message: MOLST in New York State
Next Message: orders for initiation of narc drip with prn's

Post Interface between AD's and POLST
Author: juliegethics
Date: Mar 10, 2011 12:41 pm
Our sponsoring state legislator has asked me how would adding POLST affect or change advance directives for people with current directives. I have described the clinical continuum to her. I want to be sure I'm not missing some legal/procedural snafu, however. For example, if a patient has a living will and subsequently completes a POLST and the instructives in the two conflict, what are the implications? Experiences, things to look out for, especially format/legislatively?
Replies: order by [Date] [Author] [Subject]
+ Re:Interface between AD's and POLST (by PatBomba on 03/10/2011)
In NYS, traditional advance directives like the NYS Health Care Proxy and Living Will are done while the patient has capacity and is only triggered when the patient loses medical decision-making capacity. MOLST (NYS's POLST) can be done when the patient has capacity, or by the legally appointed health care agent or surrogate decision maker. Your question underscores the importance of the discussion antecedent to completion of the MOLST/POLST. When an emergency occurs, EMS cannot interpret a living will or take orders from a health care agent. However, they can and must follow MOLST orders when the need arises. Prior to legislative change, NYSPHL only allowed community use of a simple Non-hospital DNR form. After a 3 year pilot, NYSPHL was amended to allowed an alternate form to be approved by the Commissioner of Health; that form is MOLST. In NYS, it is the only form that can provide both DNR and DNI and other signed medical orders to EMS. These are integrated into BEMS protocols: http://www.compassionandsupport.org/index.php/for_professionals/molst_training_center/ems_molst_training.

IMPORTANT: In order to post a new message or reply to an existing post in the discussion you must login. If you are not a registered member you may join here.
The statements posted in the forum section of capc.org are opinions expressed by website visitors and do not necessarily represent the viewpoints or positions of the Center to Advance Palliative Care(CAPC). CAPC is not responsible for the factual or legal accuracy of any of the statements posted.


General questions about using the CAPCconnect™ palliative care discussion forum?
Email: Jennifer.Raiten@mssm.edu

Lost login username/password questions? Email: Margaret.Schutz@mssm.edu