Moving the Goal POLST

In other news:

The Governor also conditionally vetoed S-2197, legislation providing for the use of Physician Orders for Life-Sustaining Treatment (“POLST”) forms in New Jersey. While noting the prospective benefits in guiding end of life patient care for New Jerseyans by utilizing POLST forms, Governor Christie cited concerns with the provisions of the bill that would effectively allow a patient’s wishes to be overridden by the patient’s physician or healthcare representative without the patient’s prior consent, and that would mandate an alternative dispute resolution as a prerequisite to a patient’s or his or her representative’s right to go to court to protect a patient’s wishes. Governor Christie’s recommended changes to further protect a patient’s health care wishes.

This is the bill the governor vetoed.   


This is the second time in a month where I am forced to agree with the overweight governor. (The first was his forceful and eloquent defense of appointing a Muslim to the state supreme court.) Tucked into the bill is this gem:

      If a patient who has a completed POLST form has lost
30 decision-making capacity, the patient’s representative may, at any
31 time, after consultation with the patient’s attending physician,
32 request the physician to modify or revoke the completed POLST
33 form, or otherwise request alternative treatment to the treatment that
34 was ordered on the form, as the patient’s representative deems
35 necessary to reflect the patient’s health status or goals of care.

 That certainly opens up a whole can-o-worms.  So if I decide that I wish to be allowed to die naturally and am lying in coma, my wife (who doesn't want to lose me) or my MD (for God knows what reason) may modify or revoke my previous clearly stated wish and keep me hooked up to machines until the cows come home to roost (or something to that effect).  This is a big no-no.  This is not how advanced directives work.  If I fill out a Living Will today, sign it and get it witnessed, it is a legal document that can only be changed by ME. And my proxy can only make sure my wishes are being respected, not invent a whole new set of wishes. As for my doctor, well, don't get me started on that one.
This was a unforced error on the part of the bills authors. The governor was right to call them on it, though I wonder if he couldn't have reviewed it earlier.  Now it will take who knows how long before this very important piece of legislation gets signed.