POLSTs and DNR orders are not Advance Directives

Patients complete advance directives without a physician's approval, though they may seek a physician's advice in doing so.  Only a physician can issue a DNR order or a POLST, in consultation with the patient or surrogate.  So long as the preferences and directives of patients are an integral part of the process, POLSTs appear to be a useful addition to late-stage medical care decision making

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