Medical Staff

How to follow end-of-life wishes

Hospitalist Leadership Connection, September 16, 2008

As hospitals deal with patients’ end-of-life decisions, hospitalists tend to abide by state regulations regarding default surrogates, those who make medical decisions if a hospitalized patient is incapacitated. There are currently 37 U.S. states that have regulations determining who is to be appointed surrogate, oftentimes spouse and family members. However, default surrogates tend to make decisions incongruous with the patient’s wishes, according to an article by Hospitalist News. One way to comply with the patient’s end-of-life wishes is to set up an advance directive. Consider the following practices:

  • Encourage patients to seek surrogates that have values consistent with their own, not necessarily family members.
  • Provide surrogates with information for decision making.
  • Use a form called the physician order for life-sustaining treatment (POLST). Also known as medical order for life-sustaining treatment, medical order on scope of treatment, or physician order on scope of treatment, this form includes directives on how medical staff can approach resuscitation, medical intervention, antibiotics, and general treatment.

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