The National Association of Catholic Chaplains

Menu
  • Membership
      • Apply for Membership
      • Frequently-Asked Questions about Membership
      • Request Retired Membership
      • State Liaisons
      • Newest Members
      • Membership Directory
      • Member map
      • Celebrating Our Members’ 25-year Membership and Certification
      • In Memoriam: deceased NACC members
    • Close
  • Certification
    • Initial Certification
      • Board Certified Chaplain (BCC)
      • Certified Associate Chaplain
      • Palliative Care and Hospice Advanced Certification (PCHAC)
      • VA Initial Board Certification
      • Recognition of Strategic Partners Certification
      • Newly Certified Chaplains
      • Close
    • Renewal of Certification
    • Certification Competencies & Procedures
      • Certification Competencies & Procedures
      • Important Background on NACC Certification Competencies
      • Professional Code of Ethics for Spiritual Care Professionals
      • Certification Commission
      • Certification Appeals Panel
      • Ethics Appeals Panel
      • Close
    • Mentors
    • Recognition of Strategic Partners Certification
    • Verifying Certification
    • Maintaining Certification in Retirement
    • Graduate Theological Programs
    • Close
  • Education Resources
      • 2024 NACC National Conference
      • 2023 Webinar Series
      • Recorded webinars (2009-2022)
      • Calendar of Events
      • Graduate Theological Programs
      • CPE Programs
      • NACC Professional Networking Calls
      • Continuing Education Hour Requests – Guidelines and Forms
      • Ongoing Educational Opportunities
      • Local/Regional Gatherings & Events
      • Past Conferences (2004 – 2023)
      • Vision
    • Close
  • Resources
    • Chaplaincy Resources
    • Job Listings
    • The Journal of Pastoral Care & Counseling
    • Partners in Pastoral Care
    • Pastoral Care Week / Spiritual Care Week
    • Research
    • Spirituality and Prayer Resources
    • Vision
    • Close
  • About NACC
    • About the NACC
      • Mission/Vision/Values
      • Constitution and ByLaws
      • Strategic Plan
      • History
      • Close
    • Annual Reports & Financial Reviews
    • Association Leadership
      • NACC Board of Directors
      • Committees, Commissions, and Panels
      • National Office Staff
      • Episcopal Advisory Council
      • Close
    • Choose Chaplaincy
    • Health Care Collaborators
    • NACC Annual Awards
    • NACC Merchandise
    • NACC Now
    • Partners in Pastoral Care
    • Partners for Professional Excellence in Spiritual Care
    • Vision
    • Close
  • Choose Chaplaincy
  • Contact Us
      • This field is for validation purposes and should be left unchanged.
    • Close
  • Donate Now
  • Member Login
Home » Vision » March-April 2018 » POLST might help more patients get the care they want

POLST might help more patients get the care they want

By Daniel Waters

An article published in the New England Journal of Medicine in November was picked up by many mainstream news services. The elderly man lived in a nursing home but was found unconscious on the street with alcohol in his system. Upon arrival, he was found to have “Do not resuscitate” tattooed across his chest with his name signed and the word “not” underlined. He had no identification, and there were no family and friends present. When his condition worsened, the questions intensified. What if the tattoo was there because he lost a bet in a poker game? What if the tattoo was the result of another night of drinking and that was never his true intention?

Communicating one’s end-of-life wishes clearly and effectively can be more complicated than one might realize. Part of this is the number of invasive life-sustaining measures now in use. Some form of AND (allow natural death) or DNR (do not resuscitate) orders are in common use. Now the POLST (physician’s order for life-sustaining treatment) or MOLST (medical order for life-sustaining treatment) are being used in more than 20 states and are being considered in others.

A core aspect of POLST is that it is portable. A DNR is a doctor’s order put in place when a patient is admitted to a hospital, but when the patient is discharged, the order, like other orders, is discontinued. But POLST follows the patient and does not need to be reinstituted at each admission.

POLST follows the patient and does not need to be reinstituted at each admission.

The goal is for a conversation to take place between the primary healthcare professional and patient regarding the feasible options of treatment. The primary healthcare professional answers questions and advises the patient. The POLST that can take the shape of electronic and paper notification. Chaplains can relate stories of the bright bold color of their state’s form and how it very visibly accompanies a patient arriving at an emergency room or a direct admit.

In general, a POLST form will include options: full treatment; limited or select treatment with thorough detail; or comfort measures only. Medically administered nutrition and hydration are addressed in the document. The form will include the signature of the healthcare professional and of the patient or surrogate. A form codified by a state is honored in court, and a healthcare professional can have more confidence after these provisions.

Unfortunately, some Catholic individuals and groups operate out of the fear that POLST will compromise a patient’s care or even lead to physician-assisted suicide or euthanasia. Instead, a POLST helps to ensure a patient’s desired quality of life and consultation with their healthcare professional. In November, Pope Francis addressed European members of the World Medical Association. The Holy Father directly addressed the complexity of current treatment options. He referenced the Catechism’s desire that decisions should be made by a patient who is competent and able to discuss treatment with their physician. He cautions against abandoning the sick, particularly the most vulnerable. He states that these sensitive issues should be addressed calmly, seriously, and thoughtfully.

In the case of the patient with the DNR tattoo, the hospital ethics team was consulted. Minimal treatment was initiated that would not be irreversible in the face of uncertainty. The confirming DNR paperwork was eventually secured, and the patient died the next morning. A fluorescent-colored POLST form might not have traveled with this patient anyway, but a pocket card might have. The details provided would have benefited the patient and the medical team.

The conversation regarding care is not easy. Operating out of fear of details of care overlooks the challenge of the conversation. When we listen intently to the heart of another, the difficult conversation becomes an act of God’s love.

Daniel Waters, BCC, is spiritual care coordinator at Mercy Health in Oregon, OH.

The National Association of Catholic Chaplains
Become a Member Would you like to get Certified?

Free Publications

Don’t miss the latest news, subscribe to our newsletter today! You don’t have to be a member to subscribe.

National Association of Catholic Chaplains
4915 S. Howell Avenue, Suite 501
Milwaukee, WI 53207
Get Directions

Phone: (414) 483-4898
Fax: (414) 483-6712
Email: info@nacc.org

Our office hours
Mon-Thur 8:00am – 5:00pm Central Time
Friday 8:00am – 12 Noon
Sat-Sun closed

Job Listings

Current job opportunities for chaplains, priests, CPE residents, supervisors, directors of pastoral care, managers, mission directors, and more.

Job Listings

Free Publications

Don’t miss the latest news, subscribe to our newsletter today! You don’t have to be a member to subscribe.

Donate Now

Learn more about making a tax-deductible donation to NACC.

Donate Now

Connect with us

  • Email
  • Facebook
  • Instagram
  • LinkedIn
  • YouTube
© 1997 - 2023 National Association of Catholic Chaplains - Sitemap

Built by Westwords