The POLST Paradigm Initiative began in Oregon in 1991. Medical ethics leaders recognized that patient wishes for life-sustaining treatments were not being honored consistently despite the availability of advance directives. The Center for Ethics in Health Care at Oregon Health & Science University convened representatives from stakeholder health care organizations to develop the Medical Treatment Coversheet; portable medical orders based on a patient’s values for life-sustaining treatments.
After initial evaluation and a name change to “Physician Orders for Life-Sustaining Treatment” (POLST) the form was released for use in Oregon in 1995. Using a “train-the-trainer” model, members of the task force initially educated health care professionals about use of the form. Ongoing education, research and a statewide experience-based continuous quality improvement process helped the task force improve the content of the POLST form and the process of implementation.
As Oregon’s program evolved, selected regulations rather than legislation were used to help with implementation. Other developing programs like West Virginia and New York sought legislation to facilitate POLST paradigm adoption. Each new program found that their approach needed to be thoughtfully tailored to state laws and regulations.
Amy Vandenbroucke, J.D., Chair, Oregon POLST Task Force
Amy Vandenbroucke comes to us from the Legal Department at Oregon Health & Science University where she spent over five years providing advice on a variety of issues, including medical ethics, informed consent, guardianships and health care generally. Prior to graduating from DePaul University College of Law, she worked for the U.S. Department of Health & Human Services Office for Civil Rights, the American Osteopathic Association, and the University of Chicago.
Faith English, Program Coordinator
Faith English was born and raised in Western Massachusetts where she attended Smith College. Bilingual in Spanish, Faith has worked in a variety of social service positions, including as a home visitor for teen parents, as a referrals coordinator for homeless youth in Portland, and as a case manager for homeless individuals living with HIV/AIDS.