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The Advanced Healthcare Directive


The US medical facilities are known for delivering patient-centered care. Ever since the adoption of the course for the patient agency, the recipients of healthcare services have been increasingly informed about their care, capable of making well-informed choices regarding their health and lives. According to the federal law and various statewide statutes, the patient has the final say in regards to when and how he or she is treated.

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Advanced Healthcare Directives (AD) are used to give the patient a chance to voice their wishes and opinions on how should the doctors approach their treatment plans in case of a severe injury, disability, or terminal disease. However, there are documents that fulfill these functions, such as the Physician Order for Life-Sustaining Treatment (POLST) forms. Despite similarities in both appearance and purpose, these documents are not the same. The purpose of this paper is to analyze AD and POLST within the scope of Floridian state law.

The Advanced Healthcare Directive

The AD filled out as part of this assignment was retrieved from It is a site supported by the National Hospice and Palliative care organization. The site provides access to AD forms utilized in all states, including Florida. The list of documents is updated regularly in order to ensure that it is compliant with the state law (“Florida advance directive,” 2017). The main laws that the AD needs to be compliant with are the laws regarding the creation of a living will, the designation of a healthcare surrogate, as well as various laws regarding the refusal of treatment, and the use of the body and its organs after death (“Florida advance directive,” 2017).

The AD in Florida has had some issues in the past ten years or so. Before September 2015, the document had a “springing” authority, which stated that up until a traumatic incident occurred, the AD, even if signed, had no legal power (IST, 2015). This precaution was made to prevent healthcare surrogates from abusing their power. However, it only created more issues, as until the deliberation about the magnitude of the traumatic incident was completed, the document could not bestow authority upon the healthcare surrogate.

As a result, immediate decisions were impossible to make. Since 2015, the principal is allowed to elaborate in the document on whether the healthcare surrogate would have complete authority exercisable immediately, or choose to retain the “springing” mechanic (IST, 2015). Filling out the form was not difficult. The instructions provided to the principal before and during the form filling are very elaborate and cover everything a person needs to know in order to fill it out without requiring a legal counselor (Vanderpool, 2015).

Physician Orders for Life-Sustaining Treatment (POLST) Form

A POLST form is a kind of medical document that covers specific medical treatments that a person wants to be administered to them during an emergency situation. They are typically filled out by individuals that have a serious condition that may affect them at any given moment, such as asthma, congestive heart failure, diabetes, and others (NPP, 2018). Elderly patients experiencing bodily frailty and weakness may also file these. The document is completed by the healthcare practitioner, not the principal. However, while POLST and AD work together, POLST is not a legal document. It is a medical order to healthcare professionals, and a copy of it can be easily found in the local hospital’s electronic registry (NPP, 2018).

Summary and Conclusions

POLST and AD are both advanced healthcare directives. An AD is usually filled out first, and POLST is filled out with the help of a healthcare practitioner, to be kept in the database. An AD is a legally binding document that gives juridical power to a healthcare surrogate, determines the use of organs and the body after death, and allows for certain treatments in case of injury, vegetative state, or an end-of-life procedure (NPP, 2018).

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POLST, however, is not a legal document. It does not give power to a healthcare surrogate, and only allows the use of medical treatments in an emergency, when the patient cannot speak for him or herself. It is used by emergency clinicians and is not necessary for individuals that do not have any serious debilitating ailments.

The AD, however, which is comprised of an appointment for a healthcare surrogate, a living will, and permission to administer/withhold treatments, as well as permission for organ donation, is something that all people should have. Without these documents, the doctors, the patients, and their relatives are forced to undergo a painstaking legal process to be able to comply with the patient’s wishes.

One of the core duties of nurses includes ensuring the patient’s autonomy and respect their decisions regarding their own health. If a patient is incapacitated, it is impossible to do. AD and POLST documents serve as a great help for medical professionals in guiding and inform their practice in accordance with the patient’s wishes. It helps avoid any unwanted difficulties regarding a person’s personal beliefs, religious views, and wishes. Nurses and doctors alike should spread the word about AD and POLST, in order to ensure maximum coverage.


Florida advance directive. (2017). Web.

IST. (2015). Florida revises rules for healthcare advance directives. Web.

NPP. (2018). POLST and advance directives. Web.

Vanderpool, D. (2015). EHR documentation: How to keep your patients safe, keep your hard-earned money, and stay out of court. Innovations in Clinical Neuroscience, 12(8), 34-38.

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