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For Terminally Ill, New Law Gives Final Say on Medical Care

‘Physician Orders’ ensures that patients’ end-of-life wishes are honored.

Legislation that encourages patients to decide if they want aggressive medical care at the end of life was signed into law by Gov. Chris Christie on Wednesday, moving New Jersey in line with more than 30 other states that provide residents with a relatively new planning document called the “Physician Orders for Life Sustaining Treatment” or POLST.

POLST allows individuals to remain in control when facing a life-limiting or terminal illness.“Everyone deserves to be treated with dignity and respect regarding their medical care, especially as they enter the final phase of their lives,” said Assemblywoman Nancy F. Munoz (R-Essex, Morris, Somerset and Union), the bill’s co-sponsor and a registered nurse.

POLST has to be signed by a physician or nurse practitioner, and unlike a living will, it has the authority of a physician order and becomes part of their medical records, following the patient from one healthcare setting to another, including hospital, home, nursing home, or hospice.

With POLST, the individual can chose whether or not to be resuscitated in the event of a heart attack, and can authorize a healthcare proxy to make decisions on their behalf if they become incapacitated.

POLST “will help ensure that a person’s medical treatment wishes are honored,” Munoz said.

Under the bipartisan legislation, a POLST form would only be valid if signed by the patient, or by the patient’s representative, as well as the attending physician or the advanced practice nurse, along with the date of signature. A patient can amend or revoke a POLST form, or request treatment other than what was ordered on the form. The patient can also spell out whether their healthcare representative or proxy has the authority to revoke or modify the POLST in the event the patient loses decision-making capacity.

The new law now provides for “establishing a central database where physicians, hospitals or managed care facilities can be notified of a patient’s preference for care” and is “an effective way to ensure continuity in their treatment,” Munoz said.

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