A significant update to California’s POLST framework is moving steadily through the state legislature. Senate Bill 1088, authored by Catherine Blakespear and sponsored by the Coalition for Compassionate Care of California (CCCC), has received overwhelming bipartisan support and is expected to bring several important improvements to how POLST forms are used throughout the state.
For years, POLST has stood for “Physician Orders for Life Sustaining Treatment.” These forms serve an important role in documenting a patient’s wishes regarding emergency medical interventions, resuscitation, hospitalization, and other end of life care decisions. However, SB 1088 recognizes that the current framework can be improved to better reflect modern healthcare practices and patient autonomy.
One of the most visible changes proposed by the bill is a new meaning for the POLST acronym. Under SB 1088, POLST would stand for “Portable Orders Listing Scope of Treatment.” This change reflects the reality that POLST forms are no longer exclusively completed by physicians. Nurse practitioners and physician assistants may also participate in the process under California law. The updated terminology is also intended to remove the potentially misleading phrase “life sustaining treatment,” which can imply that every medical intervention will meaningfully extend life. In many situations, particularly for frail elderly patients with advanced illness, interventions such as CPR may be unlikely to achieve that outcome.
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