Death and Dying Attitudes in California

Blog: GeriPal
February 21, 2012

In California not only ethically, but legally pursuant to California assembly bill 2747, effective January 2009, if a physician makes a diagnosis that a patient may have less than one year less to live they are ethically and legally obligated to offer to inform patients of all of their health care treatment options.

Link to blog here.

POLST and TPOPP

John Carney
July 2, 2010

There is one group of patients for whom advance care planning and goals of care can be incorporated into a single document, but the form is not available in all locales. It is designed for those living with advanced disease and is called POLST (Physician Orders for Life Sustaining Treatment) or variations on that theme.

In Kansas City we are calling it TPOPP (Transportable Physician Orders for Patient Preferences). The form actually incorporates patient goals into physician order sets dealing with treatment preferences in a variety of areas (surgery, CPR - from full to no code, antibiotics, and hydration and nutrition), so while it ends up being a set of physician orders, the process requires a discussion about treatment preferences and values and thus, advance directives.