The intent of the Physician's Order for Life-Sustaining Treatment: Reflecting patient wishes and institutional obligations

The intent of the Physician's Order for Life-Sustaining Treatment: Reflecting patient wishes and institutional obligations
Journal of Hospice and Palliative Nursing; Jeannette Jeannie Meyer; 4/25
Portable Medical Orders (PMO) such as the Physician's Order for Life-Sustaining Treatment and the Medical Order for Life-Sustaining Treatment have proven to be valuable documents that allow patients who are medically frail or have life-limiting illnesses to communicate their health care wishes. The PMO depends on a conversation between the trained health care provider and the patient or their designee. A PMO with incomplete signatures is not a valid legal document. In the scenario presented here, the author discusses a scenario in which the discussions did not take place and the signatures are questionable, leading the patient to receive aggressive medical treatment that might not be in their best interests. The reasons behind the above ethical issues are related to a misconception and misuse of the PMO within a long-term care facility. Unfortunately, as noted in the literature cited and in the author's own experience, these ethical issues are not uncommon.