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End of Life Decisions
A new study conducted by OHSU physicians looks at Oregon's registry for people who have made decisions about what kind of medical treatment they want in a life-threatening situation. The study's findings were published in the Journal of the American Medical Association. It drew on data from the 25,000 Oregonians who registered with the Physician Orders for Life Sustaining Treatment (POLST) program between December, 2009 and December, 2010.
The POLST program has been around for two decades to go further than standard "Do Not Resuscitate" orders in making hospitals aware of people's end-of-life wishes. The registry was just instituted in 2009 to help streamline communication among medical professionals about POLST, especially in crisis situations. Since then, several other states have created similar programs.
The study found that people who choose not to be resuscitated don't necessarily make the same choices about whether or not to refuse other treatments. Some prefer not to be taken to the hospital or treated for illnesses that could end their lives, while others want everything short of CPR administered in a life-threatening situation. The study found that most people want some combination of treatments available to them. The overwhelming majority of people in POLST are over 65 and many are frail or facing a terminal disease. All of them have chosen to have detailed and often difficult conversations with their doctors and family members about death and dying.
Have you taken steps to put your medical wishes down on paper? Are you enrolled in POLST? What prompted you to make the choices you've made about what kind of medical treatment you want (or don't want) at the end of your life? Have you had conversations about this difficult topic with family members?
- Susan Tolle: Physician and director of the Center for Ethics in Healthcare at the Oregon Health & Science University
- Mary Hughes: Susan Tolle’s mother and a retired microbiologist