Bill Allowing Patients To Detail End-Of-Life Treatment Preferences Heads To Governor

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State Sen. M. Teresa Ruiz

TRENTON – Legislation aimed at ensuring that people with chronic or terminal illnesses are treated with dignity and respect in their final days by ensuring their medical wishes are known by medical professionals providing them care was approved today by both houses of the Legislature. It now heads to the desk of Gov. Chris Christie.

The bill (S-2197) would establish the framework for a program that would allow individuals to use of Physician Orders for Life-Sustaining Treatment (POLST) forms in New Jersey. The POLST form is a statewide, standardized document that essentially converts a person’s wishes regarding life-sustaining treatment into a medical order. These forms are currently being used, or are in the process of being established, in more than 30 states.

“People have the fundamental right to make their own decisions regarding end-of-life care,” said state Sen. M. Teresa Ruiz (D-Essex/Union), a sponsor of the legislation. “This bill will create a program that allows patients to convey specifically how they would like to be treated in the event they lose the capacity to express their preferences regarding life-sustaining treatments. The POLST form will help to ensure that people are, in fact, able to decide how they want to live out their time here, and that their wishes are well-known by the medical professionals providing them care.”

The bill would require the Department of Health and Senior Services to establish the POLST Paradigm Program to enable patients to indicate their health care preferences through a POLST form. The state Health Commissioner would be required to designate a patient safety organization (PSO) to develop a form, and promote awareness of the program among health care professionals, emergency responders and the general public. The patient safety organization would also be responsible for providing ongoing training of health care professionals and emergency responders.

Whereas advance directives, such as living wills, in many cases are designed simply to name an individual to make health care decisions for the patient if he or she becomes incapacitated, a POLST form provides a specific and detailed set of instructions for a health care professional as to the patient’s preference for the use of various medical interventions.

Under the 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 at any time would be permitted to amend or revoke a POLST form, or otherwise request treatment other than what was ordered on the form. In completing a POLST form, a patient would also determine whether their representative would have the authority to revoke or modify the POLST in the event the patient loses decision-making capacity.

The Senate gave final approval to the bill by a vote of 37-0. The Assembly approved the bill by a vote of 66-1-4.

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