Oregon POLST Newsletter

Paula Span’s article, Filing Suit for ‘Wrongful Life’, in the January 22nd edition of The New York Times describes a growing number of lawsuits for failure to find and honor orders to limit treatments. The article highlights the story of an unwanted resuscitation in a patient with a New York MOLST form. It features the Oregon POLST Registry as the state's effective backup system for assuring that POLST forms can be easily found, if they are not physically available in a time of crisis.

Oregon founded the POLST Program 30 years ago as a way to record patient wishes as medical orders that reflect their desire to have or to limit medical treatments. People with serious illness or advancing frailty have a right to refuse resuscitation and intensive care. The Oregon POLST Registry was established in 2009 as a repository for Oregon POLST forms to ensure that these medical orders can be located and acted upon immediately.

In this story, we read a touching account of a same-sex couple facing a serious cancer diagnosis. In the LGBTQ+ community, if a couple is not married, decisions about medical care will often go to the family of the partner who is ill, not to their partner. Family members may not know the wishes of the person who is ill. However, the partner who does know those wishes might be left out of the conversation when important decisions about health care are made.

As Gary tells us," They are your decisions to make. You can help to take the grief away from the people you love when you complete a POLST."

As reported in the February edition of the Pennsylvania POLST Newsletter, Susan Tolle, MD, Chair of the Oregon POLST Coalition and Director of the Center for Ethics in Health Care, presented the webinar POLST & COVID-19: Supporting those who are Frail and Seriously Ill in Challenging Times as part of the Oregon Statewide Lecture Series.

After reviewing the likelihood of a frail elder surviving COVID-19, Dr. Tolle discussed how providers can assure that existing POLST orders match their patients' current treatment wishes, and provided strategies for overcoming the logistical challenges of completing a POLST virtually. Dr. Tolle’s lecture can be found on the Oregon POLST website or accessed directly here.

For a third consecutive year, 'yes' to CPR submissions to the Oregon POLST Registry are down! This steady decline of more than 10% marks a dramatic shift and is due to a concerted effort among our Coalition member organizations and messaging from the Oregon Medical Board.

Nevertheless, this continued success does not mean that we can let down our guard. As reported in last December's newsletter, there is still a spike in POLST orders for 'yes' to CPR at age 65, which requires further vigilance for any potentially age-related ACP incentive connected to Medicare Wellness visits or any other impetus for counting of POLST forms.