2007: POLST Honored in All Oregon Acute Care Facilities and PAs Included as Signers
In 2006, some emergency physicians and health care systems raised concerns about following POLST orders signed by a health care professional who was not on their medical staff. In order to clarify this issue, the task force worked with the Oregon Medical Board (OMB) to establish new administrative rules. In addition, leaders in the physician assistant (PA) professional community requested that PAs be considered as signers of POLST orders. In 2007, the Board included PAs in rule changes regarding respecting orders for life-sustaining treatment in all Oregon health care facilities. OAR 847-010-0110 states:
(1) A physician or physician assistant licensed pursuant to ORS Chapter 677 shall respect the patient's wishes including life-sustaining treatments. Consistent with the requirements of ORS Chapter 127, a physician or physician assistant shall respect and honor life-sustaining treatment orders executed by a physician, physician assistant or nurse practitioner. The fact that a physician, physician assistant or nurse practitioner who executed a life-sustaining treatment order does not have admitting privileges at a hospital or health care facility where the patient is being treated does not remove the obligation under this section to honor the order. In keeping with ORS Chapter 127, a physician or physician assistant shall not be subject to criminal prosecution, civil liability or professional discipline.
(2) Should new information on the health of the patient become available the goals of treatment may change. Following discussion with the patient, or if incapable their surrogate, new orders regarding life-sustaining treatment should be written, dated and signed.