POLST: Definition and How It Works in California
A POLST, short for Physician Orders for Life-Sustaining Treatment, is a medical order signed by a seriously ill patient and a clinician. It tells emergency responders and hospital staff which life-sustaining treatments the patient wants, in a form doctors and paramedics can act on immediately.
How it works in California
Ridley Law’s comparison of the advance health care directive, the living will, and the POLST explains how this form fits alongside a person’s other planning documents. Prob. Code, §§ 4780 through 4786 govern the form. Under § 4780, it has to be signed both by an individual with capacity, or their legally recognized health care decisionmaker, and by a physician, nurse practitioner, or physician assistant, based on the patient’s own preferences and medical condition.
No statute requires a health care provider to follow a POLST. Prob. Code, § 4782 instead protects a provider who honors a properly completed POLST in good faith from criminal prosecution, civil liability, and professional discipline for doing so. That protection is what encourages providers to follow the form, but it is not a mandate.
Why it matters
A POLST is meant to travel with a seriously ill patient and be followed in an emergency, when there is no time to track down an agent or read a longer directive. For example, a patient with a terminal diagnosis completes a POLST specifying no resuscitation; paramedics called to the home can act on that order immediately, instead of defaulting to full resuscitation while someone tries to reach a family member or locate other paperwork.
Common mistakes
Assuming a POLST replaces an advance health care directive; a POLST is a medical order for someone who is already seriously ill, not a substitute for naming an agent or writing broader instructions. Assuming a provider must follow a POLST no matter what; the law protects providers who honor one, it does not force compliance. Completing a POLST too early, for someone who is not yet seriously ill, when a living will or advance directive is the more appropriate document.
Related terms
- Advance Healthcare Directive: the broader planning document that names a health care agent, meant for anyone, not just someone already seriously ill.
- Living Will: the treatment-instructions portion of an advance health care directive, distinct from a POLST’s clinician-signed medical order.
Part of the California estate planning glossary. For the full treatment, see AHCD vs Living Will vs POLST – A California-Specific Guide to End-of-Life Documents.
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