Making the Most of Advance Directives

During 2011 the University of Colorado chapter of GHHS joined a national grassroots effort to empower patients and help physicians make sound decisions to fulfill patients’ end of life wishes.

In an outreach to more than 500 medical students, residents and physicians, the GHHS chapter made presentations on Colorado’s end-of-life directives, called MOST (Medical Orders for Scope of Treatment). The members encouraged conversations be initiated by providers to help patients make decisions about their wishes and how their physicians could fulfill them.

Joshua R. Potocko, a GHHS participant in the project, credits Oregon palliative care experts with the creation of POLST (Physician Order for Life-Sustaining Treatment) that serves as a model for the Colorado version. The MOST form is designed to travel with the patient and covers four sections: CPR directives, medical interventions, and guidance on use of antibiotics and artificial nutrition and hydration.

Potocko explained, “ [The] MOST form has the potential to provide peace of mind… [help patients] seize some modicum of control during a time when command of their lives is terribly lacking…and [also] inform providers to make quick, sound decisions knowing a patient’s best interests have been carefully discussed and documented. The major lesson-learned for our GHHS group, above all, is that even small steps can have a big impact on the humanistic practice of medicine.”