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When it comes to life sustaining treatment, it is most important that you discuss your choices and concerns about medical care and treatment with your physician, prior to admission to the hospital, and that you share your decisions with your family.
Below are the Federal and Pennsylvania laws, as well as, Warren General Hospital’s position on end-of-life care.
Questions about medical care at the end-of-life are a great concern today, partly because of the growing ability of medical technology to prolong life and partly because of highly publicized legal cases involving comatose patients whose families wanted to withdraw treatment.
The Patient Self-Determination Act of 1990 requires that hospitals inform patients of their right to withhold or withdraw treatment after reaching an advanced stage of a terminal illness or permanent unconsciousness according to hospital policy.
The Pennsylvania Orders for Life-Sustaining Treatment (POLST) is tool used by the medical team, through conversation with a patient and/or family, to summarize a patient’s treatment choices in the form of written medical orders about treatment goals for end-of-life care.
It is designed to be used across health care settings, so that the wishes of the patient can be carried out in any setting, from hospital to hospice care.
POLST differs from an advance directive (living will or health care power of attorney) in that it is an actionable medical order dealing with the here-and-now needs of patients—it builds on an advance directive, but can be created for patients without an advance directive, as well.
Warren General Hospital will provide life-sustaining treatment, including resuscitation efforts, to patients for whom it is indicated, unless there are specific physician orders to the contrary in the medical record. It is the responsibility of the patient’s attending physician to determine that the patient is in a terminal condition or is permanently unconscious. Declarations do not go into effect if a patient has the capacity to communicate to his/her physician. If that is the case, decisions have always, and should continue to be, made jointly by the doctor and patient. For patients that are unable to make their own decisions about life-sustaining treatment, the patient’s family will be asked to make them.