{"id":98,"date":"2019-11-01T03:53:25","date_gmt":"2019-11-01T03:53:25","guid":{"rendered":"https:\/\/www.citruscountyrighttolife.com\/?page_id=98"},"modified":"2019-11-01T03:53:25","modified_gmt":"2019-11-01T03:53:25","slug":"state-legislation","status":"publish","type":"page","link":"https:\/\/www.citruscountyrighttolife.org\/?page_id=98","title":{"rendered":"State Legislation"},"content":{"rendered":"\n

A POLST Primer<\/strong>
by Mr. Jan Halisky, Attorney at Law<\/em><\/p>\n\n\n\n

On October 28th, 2015, Pinellas County Senator Jeff Brandes introduced a bill entitled \u201cPhysician Orders for Life Sustaining Treatment (POLST)\u201d. POLST is an oxymoron. In our view, rather than sustaining lives, POLST will only open the door wider to covert euthanasia.<\/p>\n\n\n\n

It is important to know first of all what organizations are driving POLST. The POLST concept originated at the Oregon Health and Science University Center for Ethics in Health Care (OHSU CFE). The National POLST Paradigm Task Force, which lobbies states to implement the use of POLST forms, has its national office at OHSU CFE. This connection is important to know because OHSU CFE was also responsible for producing the Oregon Death with Dignity Act: a Guidebook for Health Care Professionals, meant to help physicians implement requests for assisted suicide. Two members of the POLST Paradigm Task Force, Patrick Dunn, M.D., and Susan Tolle, M.D., were involved in issuing the Guidebook. Under the Oregon law, \u201cdeath with dignity\u201d is a euphemism for physician assisted suicide.<\/p>\n\n\n\n

POLST is also being pushed by the Hemlock Society, now known as Compassion and Choices. The Hemlock Society was founded by Derek Humphrey, who helped his first wife kill herself. Humphrey\u2019s second wife committed suicide too, after he abandoned her when she got breast cancer. A number of people have committed suicide using the do it yourself death information contained in Humphrey\u2019s book, Final Exit<\/em>.<\/p>\n\n\n\n

Florida\u2019s state coordinator for POLST is the FSU Center for Innovative Collaboration in Medicine and Law. In its inaugural \u201cFlorida POLST Newsletter\u201d the Center openly linked to the Hemlock Society of Florida, mentioning its collaboration in a POLST legislative advocacy campaign.<\/p>\n\n\n\n

Besides our fears about the aims of its national and state advocates, here is a list of specific dangers we find in this legislation:<\/p>\n\n\n\n

1. The POLST concept would now move the physician to the front line in procuring a patient\u2019s end-of-life care decisions. The Florida Statutes already authorize Advance Directives for this purpose. Advance directives are typically prepared by individuals in a reflective atmosphere with consultation from one\u2019s family. This is the framework chosen by the legislature to best reflect patients\u2019 real desires and to protect them from outside pressures. On the other hand, a brief face to face meeting with a physician is neither deliberative nor equal. In 1982 the President\u2019s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research issued a report titled, Making Health Care Decisions: the Ethical and Legal Implications of Informed Consent in the Patient\/Practitioner Relationship.<\/em> That report stated at page 67:<\/p>\n\n\n\n

A professional\u2019s careful choice of words or nuances of tone and emphasis might present the situation in a manner calculated to heighten the appeal of a particular course of action.<\/p>\n\n\n\n

It is well known that the way information is presented can powerfully affect the recipient\u2019s response to it. The tone of voice and other aspects of the practitioner\u2019s manner of presentation can indicate whether a risk of a particular kind with a particular incidence should be considered serious. Information can be emphasized or played down without altering the content, and it can be framed in a way that affects the listener\u2026<\/p>\n\n\n\n

Because many patients are often fearful and unequal to their physician in status, knowledge, and power, they may be particularly susceptible to manipulations of this type.<\/p>\n\n\n\n

2. Once signed by the physician, the POLST form becomes an actionable medical order which would supercede the patient\u2019s advance directive. If it is inconsistent with the advance directive, then the physician and the facility put themselves at odds with the patient\u2019s express written instructions. Moreover, the consultative role of the patient\u2019s family is eliminated. Conflicts of interest are created between physicians and their patients<\/p>\n\n\n\n

3. The patient does not fill out the form. The physician does. It is thus his form, not the patient\u2019s.<\/p>\n\n\n\n

4. Florida Statute 765.110 (2) already
provides that a patient\u2019s advance directive shall travel with the patient as part of the patient\u2019s medical record. POLST forms are therefore unnecessary, unless one infers an implied intent in the bill to allow the advance directive to be undermined if a physician, on his own, intervenes.<\/p>\n\n\n\n

5. The proposed bill did not contain a conscience clause that protects facilities or practitioners unable to follow a POLST order due to their ethical concerns.<\/p>\n\n\n\n

6. POLST forms are typically based on a simplistic checklist. Such checklists are unreliable in the real world because information necessary for making good judgments about health care is complex and cannot be entirely foreseen ahead of time. The checklist is open to \u201cone size fits all\u201d abuse.<\/p>\n\n\n\n

7. No witnesses are required for POLST. On the other hand Chapter 765 F.S. requires them for Advance Directives. Under POLST one has only the physician\u2019s statement that the document reflects the patient\u2019s wishes. There are no adequate patient safeguards.<\/p>\n\n\n\n

8. Under existing state and federal constitutional law, once a patient has documented his or her preferences, the only person who may override those decisions is the patient, not a physician. POLST therefore impinges on patient self determination.<\/p>\n\n\n\n

9. In states which have POLST, experience has demonstrated that POLST results in refusal of life sustaining treatments in numbers much greater than Advance Directives do (98.1% vs. 16.1%). Why would this be if there were not an inherent bias toward death in the POLST process?<\/p>\n\n\n\n

Thankfully POLST was not passed this year. But we expect that the POLST bill will be filed once again in the upcoming 2017 legislative session. In the meantime, we would ask that our readers contact all the members of the Pinellas legislative delegation asking that they please work against and vote against POLST. The legislature should not cooperate with the Hemlock Society and other pro-euthanasia organizations which are pushing this bill. Here is the contact information for the Pinellas legislative delegation:<\/p>\n\n\n\n

Senator Jack Latvala
26133 U.S. Highway 19 North
Suite 201
Clearwater, FL 33763
Tel: (727) 793-2797<\/p>\n\n\n\n

Senator Arthenia Joyner
508 West Dr. Martin Luther King, Jr. Boulevard
Suite C
Tampa, FL 33603-3415
Tel:(813) 233-4277<\/p>\n\n\n\n

Senator Jeff Brandes
9800 4th Street North
Suite 200
St. Petersburg, FL 33702
Tel:(727) 563-2100
Representative Chris Latvala
Suite 206
2963 Gulf to Bay Boulevard
Clearwater, FL 33759-4200
Tel: (727) 724-3000<\/p>\n\n\n\n

Representative Darryl Rouson
Suite 312
535 Central Avenue
St. Petersburg, FL 33701-3703
Tel: (727) 552-3200<\/p>\n\n\n\n

Representative Larry Ahern
Suite B
8383 Seminole Boulevard
Seminole, FL 33772-4392
Tel: (727) 395-2512
Representative Chris Sprowls
Suite 100
2364 Boy Scout Road
Clearwater, FL 33763-0901
Tel: (727) 793-2810<\/p>\n\n\n\n

Representative Kathleen Peters
Suite 203
1700 66th Street North
St. Petersburg, FL 33710-5510
Tel: (727) 341-7385<\/p>\n\n\n\n

Representative James Grant
12972 North Dale Mabry Highway
Tampa, FL 33618-2806
Tel: (813) 265-6272<\/p>\n","protected":false},"excerpt":{"rendered":"

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