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Title
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Overcoming Legal Impediments to Physician Orders for Life-Sustaining Treatment.
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Creator
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Kapp, Marshall B.
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Abstract/Description
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The Physician Orders for Life-Sustaining Treatment (POLST), otherwise known as the POLST paradigm, represents the next generation in end-of-life (EOL) planning for certain patients who wish to exercise prospective control over their own medical treatment in their final days. As is true for any physician treatment orders, a POLST is written in consultation with the patient or patient’s surrogate. There are a number of practical impediments to widespread adoption and implementation of the POLST...
Show moreThe Physician Orders for Life-Sustaining Treatment (POLST), otherwise known as the POLST paradigm, represents the next generation in end-of-life (EOL) planning for certain patients who wish to exercise prospective control over their own medical treatment in their final days. As is true for any physician treatment orders, a POLST is written in consultation with the patient or patient’s surrogate. There are a number of practical impediments to widespread adoption and implementation of the POLST paradigm in medical practice. One of these impediments has to do with some physicians’ anxiety about potential negative legal repercussions they might suffer for writing or following a patient’s POLST; this is the focus of the present article. After describing the POLST paradigm and physicians’ anxieties about it, this article argues that the feared potential negative legal consequences of writing or following a patient’s POLST are not well founded. Instead of succumbing to legal and ethical paralysis, resulting in the failure to integrate the POLST paradigm robustly into practice, physicians should feel comfortable under current and developing law to write and honor POLSTs for appropriate patients. This article explains the basis for such physician comfort.
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Date Issued
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2016-09
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Identifier
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FSU_libsubv1_scholarship_submission_1474465770, 10.1001/journalofethics.2016.18.09.peer1-1609
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Format
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Citation
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Title
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The Physician's Responsibility Concerning Firearms and Older Patients.
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Creator
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Kapp, Marshall B.
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Abstract/Description
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The possibility of firearms ownership and possession by an older patient raises a number of issues with potential legal ramifications for the primary care physician. This article addresses some of the most salient of those law-related issues. It commences with a brief outline of gun regulation in the U.S. An enumeration of some of the specific aspects of gun ownership and possession by older persons ensues. I then comment on the collective role of the medical profession regarding firearms as...
Show moreThe possibility of firearms ownership and possession by an older patient raises a number of issues with potential legal ramifications for the primary care physician. This article addresses some of the most salient of those law-related issues. It commences with a brief outline of gun regulation in the U.S. An enumeration of some of the specific aspects of gun ownership and possession by older persons ensues. I then comment on the collective role of the medical profession regarding firearms as a public health matter, followed by ideas about the individual physician’s appropriate role at the micro level regarding firearms within the context of the physician/older patient professional relationship. Specific attention is devoted to physicians’ rights in this arena and to policy arguments about converting those rights into legally enforceable obligations. The article concludes that it is undesirable for statutes to be enacted by state legislatures, but proper for common law to evolve through changes in professional practice and opinion in the direction of, imposing affirmative requirements on physicians to inquire about firearms ownership or possession by older patients and to counsel certain patients and their family members regarding associated dangers. Additionally, the law should recognize and encourage physician discretion to protect patients and third parties at foreseeable risk by intervening through notifications about suspected dangers to proper agencies and authorities, but such protective actions should not be mandated routinely by state statutes or judicial precedent.
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Date Issued
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2016-03-01
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Identifier
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FSU_libsubv1_scholarship_submission_1468503840
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Format
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Citation
