Laws & Regulations
Neither the Oregon POLST Program or form was created through legislation. Instead, Oregon used a “grassroots approach” to gain clinical consensus and to integrate and establish POLST as the standard of care.
EMS Scope of Practice
In 1999, the Oregon Medical Board changed its administrative rule defining the scope of practice for EMTs/First Responders, requiring such emergency personnel to respect POLST forms (OAR 847-035-0030(6)). The rule states:
An Oregon-certified First Responder or EMT, acting through standing orders, shall respect the patient’s wishes including life-sustaining treatments. Physician supervised First Responders and EMTs shall request and honor life-sustaining treatment orders executed by a physician, nurse practitioner or physician assistant if available. A patient with life-sustaining treatment orders always requires respect, comfort and hygienic care.
Health Care Professional Legislation
Physicians and Physician Assistants are required by Oregon Administrative Rules to honor POLST forms (OAR 847-010-0110). The rule 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.
Related POLST Legislation
POLST is also referenced in the following Oregon Statutes and Administrative Rules
OAR 411-066-0020(2)(b)(M) - Concerning Registration and Certification Standards for Adult Day Services Programs
OAR 411-045-0040(4)(b)(M) - Concerning Program of All-Inclusive Care for the Elderly (PACE)
OAR 411-050-0444(7)((a)(E)(v) and -0447(2)(c) and -0447(6)(c)(A)) - Concerning Licensure of Adult Foster Homes