Bishops Urge Against Use of Provider Orders for Life-Sustaining Treatment
MADISON, Wis. (July 25, 2012) -- The Roman Catholic bishops of Wisconsin recently expressed concern for "Upholding the Dignity of Human Life" in a statement warning against the use of Physician (or Provider) Orders for Life-Sustaining Treatment (POLST).
POLST is a preset form that establishes medical orders to withhold or administer treatments. When signed by certain designated health care professionals, the form dictates whether to withhold or administer treatments such as cardiopulmonary resuscitation (CPR), antibiotics, or nutrition and hydration.
Respect Dignity of Every Human Life
WCC End of Life Statements
CLICK HERE for "Upholding the Dignity of Human Life"
Affirming that "[e]very human being, created in the image and likeness of God, has profound dignity," the bishops stressed that, "[t]hroughout our lives we must always make choices that respect the dignity of every human life from the moment of fertilization to natural death."
Noting that the use of POLST has grave implications for human dignity, the bishops observed, "[a] POLST form presents options for treatments as if they were morally neutral. In fact, they are not. Because we cannot predict the future, it is difficult to determine in advance whether specific medical treatments, from an ethical perspective, are absolutely necessary or optional."
POLST Oversimplifies Decisions
"A POLST oversimplifies these decisions," continued the bishops, "and bears the real risk that an indication may be made on it to withhold a treatment that, in particular circumstances, might be an act of euthanasia. Despite the possible benefits of these documents, this risk is too grave to be acceptable."
The bishops also took issue with the form's use, citing its possible conflict with an individual's wishes, Wisconsin law, and hospital or practitioner ethics. The bishops pointed to the form's lack of patient signature and the absence of a conscience clause to protect facilities or practitioners as deficiencies that jeopardize respect for the dignity of human life.
The bishops stated that "Due to the serious and real threats to the dignity of human life that POLST and all similar documents present, we encourage all Catholics to avoid using all such documents, programs, and materials. The POLST form should not be regarded as the standard model for designating treatment preferences."
Affirm Durable Power of Attorney for Health Care
The bishops, however, affirmed advance care planning generally and suggested the use of a different instrument.
"We encourage all persons to use a durable power of attorney for health care. For those who are age 18 or older, completing this document allows you to appoint a trusted person to make health care decisions on your behalf if a situation arises in which you cannot make these decisions for yourself. It is important to discuss your wishes and Catholic teaching with the person whom you appoint and to choose someone who will make health care decisions based on these principles."
Church Stance on Medical Treatment
The statement also acknowledged the Church's stance on what is permissible regarding medical treatment. The bishops referenced the Catechism of the Catholic Church, which states:
"Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of 'over-zealous' treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected. (CCC, no. 2278)"
Cite General Norm
Clarifying that as a general norm, "food and water should always be provided, even if delivered by artificial means," the bishops explained when artificial nutrition and hydration are "morally optional." They also directed those interested in obtaining more information on care and treatment issues to their earlier publication, "Now and at the Hour of Our Death."
Both the bishops' statement on "Upholding the Dignity of Human Life" and "Now and at the Hour of Our Death" are available through the Wisconsin Catholic Conference website,
For more information, contact Kim Wadas at 608-257-0004.