January 15, 2009

Ask The Lawyer

POLST comes to California to assist consumers

This week's question:
I have been reading your column for several years and it looks like it may be time for another one based on new laws coming into play for us consumers. Have you seen anything of interest for 2009?

Brenda B.
Almaden Valley


Dear Brenda,
First of all, thank you for your interest in this column. That is appreciated and not taken for granted.

As a matter of fact, I have seen several new laws of interest to California consumers that take effect with the new year. Unfortunate-ly, space in this column does not allow for a full discussion of very many. So let me focus on just one new law for 2009 in the field of estate planning, living trusts and Advance Health Care Directives.

On Aug. 4, California Gov. Arnold Schwarzen-egger signed Assembly Bill (A.B.) 3000 into law. This bill amends the California Probate Code to add a recognition of Physician Orders for Life-Sustaining Treatment (POLST) forms to the current recognition of “do not resuscitate” (DNR) forms.

In short, the POLST program is designed to improve the quality of care people receive at the end of life. It is based on effective communication of patient wishes, documentation of medical orders on a brightly colored form and a promise by health care professionals to honor these wishes.

This new law does not require the use of a POLST form, but describes the requirements if one is used. According to the California Coalition for Compassion-ate Care Web site, the POLST form is a physician’s order that outlines a plan of care reflecting the patient’s wishes concerning care at life’s end. The POLST form is voluntary and is intended to:

—Help the doctor and the patient discuss and develop plans to reflect the patient’s wishes

—Assist physicians, nurses, health care facilities, and emergency personnel in honoring a person’s wishes for life-sustaining treatment.

You can access the California Coalition for Compassionate Care Web site by going to: www.finalchoices.org. There you or your doctor can download the 2009 California POLST form and even learn how to copy and print the form on 65# cover pulsar pink paper stock. Wausau Pulsar Pink card stock is available online and at some office supply stores. It is important to use this specific color of paper so that the form can be photocopied and faxed.

When you download the form, you can see that it is indeed entitled “Physician Orders for Life-Sustaining Treatment (POLST).” There are four main areas. Area “A” deals with cardiopulmonary resuscitation (CPR). One can check either “attempt CPR” or “do not attempt resuscitation/ DNR (allow natural death).

Area “B” is entitled “medical interventions” and you can check one of three boxes. One box is for “comfort measures only.” The second box to check is “limited additional interventions” and the third box is “full treatment.”

Area “C” on the “POLST” form is “artificially administered nutrition” where you can make one of three choices.

And area “D” on the form is for signatures and a summary of the medical condition.

The POLST form directs a health care provider as to the resuscitative and life-sustaining measures selected by a patient concerning the end of life, and requires health care providers to treat individuals in accordance with their POLST across all health care settings, beginning on Jan. 1.

The POLST form is provided by the health care provider and is based on the patient’s wishes and medical indications. It must be signed by a physician and by either the patient, only if competent, or the patient’s legally recognized health care decision maker, if the patient lacks capacity or the patient has designated an Advance Health Care Directive that gives the decision maker authority effective immediately.

One of the advantages of the POLST form is that it gives more detailed instructions compared with an Advance Health Care Directive or in a typical DNR order.

Can you revoke your POLST at any time? Yes you can, assuming you have the legal capacity to do so.

Donald J. DeVries
Almaden Valley


Donald J. DeVries is an attorney practicing law in Almaden Valley. If you would like him to answer your question in his next Almaden Times column, you can reach him by e-mail at don@almadenvalleylawyers.com, fax at (408) 268-6502, telephone at (408) 268-9500, or mail at, 6475 Camden Avenue, Suite 200, San Jose, CA 95120. Your matters are personal and private, so of course, he will not disclose your identity or any details about your situation. To view Almaden Times columns since 1986 visit www.almadenvalleylawyers.com. DeVries writes this column to provide you with general information about important legal matters affecting California residents—not to give you legal advice about your specific matter. No attorney-client relationship is created by these articles. The law is complex and constantly changing and varies from state to state. So you should consult an attorney before taking any action that would affect your personal or business matters.