Dalhousie Law Journal


Physician Orders for Life Sustaining Treatment, POLST, end of life, chart, euthanasia, ethics


The Physician Orders for Life Sustaining Treatment (POLST) is a one-page transferrable medical chart insert designed to facilitate physician-patient communication about a patient's wishes at the end of life. The document as a chart addition is in widespread use today, but various criticisms have been leveled at POLST, the most serious being that POLST creates a slippery slope to illicit active euthanasia. This article examines the criticisms and finds that they fit two categories, the first being practical implementation problems. These problems are correctable given more and better training of medical care staff. The second and more serious ethical charge is that POLST contributes to a culture that is moving toward endorsing euthanasia, but this is difficult to justify given POLST's history, the intentions of those who have designed and implemented it, and the lack ofany evidence that POLST does, or even could in present form, serve such an end. The analysis offered will propose that the more serious ethical criticism is actually grounded in a particular sectarian religious perspective, so that the criticism that POLST is euthanasia-bound fails to meet the requirements of a reasonable universalizable ethical perspective.