SB3076, The Illinois Physician's Order for Life-Sustaining Treatment [POLST] bill and amendment passed the Health Care Licenses Committee and are on the House floor for a vote.
What can I do?
(1) Please contact your state representative today to urge them to vote NO on SB 3076. You can find contact information for your state legislators at (217) 782-2000 or visit: http://www.elections.il.gov/DistrictLocator/DistrictOfficialSearchByAddress.aspx
(2) Please pass this on to others and encourage them to contact their state legislators too.
Here is why we oppose this bill...
The Illinois Physician's Order for Life-Sustaining Treatment or "POLST" form, which gives no distinctions for terminal and non-terminal conditions, is more for removing "life-sustaining" treatment than for protecting patients with "life-sustaining" treatment. SB 3076 would change the long-standing relationship of doctor and patient in matters of end-of-life decisions by having nurses and even less qualified physician's assistants talk to patients about these decisions and authorize "actionable medical orders" including "do-no-resuscitate" orders even in non-terminal situations.
A patient who signs a POLST form can check a box "do-not-attempt-resuscitation" if he/she stops breathing and the pulse stops. This is an "actionable medical order" to do nothing even if CPR would clearly be called for in a medical situation. For example, an allergic reaction to a medication can stop the breathing and pulse, but most patients would want to have CPR. The POLST form says NO.
Also, many elderly and frail patients may not understand the various options available to them with a POLST form, and so should have better education and options that the POLST form does not give.
Pro-Life has broad concerns with the POLST forms. One clear concern is that private foundations that have put their money into promoting POLST have also given large amounts of money to the Euthanasia organizations.
How POLST Works
You may be approached by a doctor, social worker, nurse or chaplain about refusing medical treatments at the end of your life.
Next, a brightly colored one page medical order with boxes checked, called the Physician's Order for Life-Sustaining Treatment (POLST), will be put in your medical record. You might get to see it and sign it; or, you may not. (The patient's signature is optional on forms used in Wisconsin. Even where it is required, others are signing for patients without telling them.)
A California study found doctors often signed POLST forms without meeting with patients. In the study: 57% of POLST forms were completed by non-health care professionals such as admissions coordinators or business managers of nursing homes; another 15% were completed by nurses and nurses' aids, bringing the total prepared by non-physicians to 72%.
"Facilitators" who may have no medical training are often the only ones who present a POLST to patients according to Rita Marker of the Patients Rights Council. She says these facilitators are "basically taught to follow a script;" they might say things such as "We find that most people would not want to continue to live in a vegetative state." They "focus on what you wouldn't want" done. (A typical POLST can refuse resuscitation, hospitalization, intensive care, medical interventions, IVs for delivering drugs and fluids, antibiotics, and feeding tubes.)
The POLST goes into effect as soon as a doctor or physician's assistant signs it. It says, "When the need occurs, first follow these orders, then contact physician." It must be obeyed instantly and without regard to judgments of the medical team on the scene or decisions by your family. Your Power of Attorney for Health Care is overridden by the medical team as they follow the POLST, cutting your selected decision-maker out of the process.
Not What Most People Want
Dying when you could have recovered probably is not what you thought would happen when you talked about your end of life wishes. If we can recover, almost all of us want medical treatment.
You probably will be assured you can always change your mind, but that is unlikely. Up to 76% of us are unable to express our wishes when we need end of life care. So, if you are unable to express your wishes and you could recover, but the POLST refuses medical treatment, nothing will be done except to ease you through the dying process.
Even if you could recover, without medical treatment per the POLST you probably will die. In the unlikely event that you survive, you might be disabled due to lack of prompt medical treatment. Of course, if you agree to no IV or no feeding tube, you will definitely die of dehydration. No one will know if you could have recovered unless your family has your body autopsied.
Another problem is that you're trying to make decisions today that may not come into effect for five or ten years," according to Dr. John Brehany Ph.D., Executive Director of the Catholic Medical Association. "You don't know what your condition will be and what medical advances will have been made by then. You're 60 and healthy, and you're asked 'Do you want to be hooked up to a lot of machines?' But when the same person is 70 and might be going through a temporary rough patch, nothing will be done because of the POLST signed a decade earlier."
Abuse and Misuse of POLST
A survey of California nursing home Ombudsman "revealed a very disturbing level of misrepresentation and misuse of POLST." Almost three-fourths (73%) reported nursing home residents were told they had to have a POLST, even though the law says it is voluntary. They were also told it was harder to revoke than the law allows. Handouts supplied with the POLST were characterized as manipulative. As mentioned earlier, the California study revealed doctors frequently signed POLST without talking to patients. The same study said 58% of doctors had signed "advisory" POLSTs without patients' consent and presumably knowledge.
Patient advocate, Julie Grimstad, L.P.N. says "POLST leaves the patient wide-open for abuse. POLST sets the stage for neglect, substandard medical treatment, and cost-saving at the expense of patients' lives. Although POLST promoters steer clear of mentioning the money motive, it is undoubtedly a factor in efforts to limit treatment. " She's right. Death is always cheaper.
Please contact your state representative today to urge them to vote NO on SB 3076. You can find contact information for your state legislators at (217) 782-2000 or visit: http://www.elections.il.gov/DistrictLocator/DistrictOfficialSearchByAddress.aspx
