What is the purpose of advance directives and POLST in end-of-life care?

• A. To document patient preferences for treatment when they cannot communicate, guiding care aligned with values.
• B. To mandate physician decisions about all treatments.
• C. To replace all medical decisions with palliative care.
• D. To ensure aggressive life-prolonging interventions regardless of patient wishes

Answer: (A)

The central idea is to ensure end-of-life care reflects the person’s own values and wishes, especially when they can’t speak for themselves. Advance directives are documents that capture preferences for future care and appoint someone to make decisions if capacity is lost. They guide what kind of treatments the person would or would not want, and they help surrogates and clinicians act in line with those values.

POLST (Physician Orders for Life-Sustaining Treatment) takes that a step further by turning the goals into concrete medical orders that travel with the patient and guide care across settings. It focuses on current goals and translates them into actionable decisions about life-sustaining treatments, such as whether to attempt resuscitation, intubation, hospitalization, or other interventions, and it’s designed to be updated as the person’s situation or wishes change.

So the best description is that these tools document and communicate a patient’s treatment preferences for times when they cannot communicate, guiding care to align with what matters most to them. They aren’t about forcing physician decisions, replacing all medical judgment, or guaranteeing aggressive interventions.