Talk:Physician Orders for Life-Sustaining Treatment

Untitled

This page seems pretty much like a promotion for POLST, which is highly controversial and has been criticized by Catholic, pro-life, and disability-rights organizations. Needs to be NPOV. — Preceding unsigned comment added by 75.60.108.73 (talk) 02:45, 12 April 2013 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 29 June 2020 and 21 August 2020. Further details are available on the course page. Student editor(s): Y.Ma100, P. Lee UCSF, Rmondal, UCSF, C. Lin, Future UCSF Pharm.D.. Peer reviewers: DLPHAN.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 02:21, 18 January 2022 (UTC)

Research on POLST forms

added the limitations to researching polst forms (P. Lee UCSF (talk) 21:39, 31 July 2020 (UTC)) added a 2014 study to the list of research studies (C. Lin, Future UCSF Pharm.D. (talk) 16:26, 4 August 2020 (UTC))

history

expanding on the history and adding any other significant dates (P. Lee UCSF (talk) 21:37, 31 July 2020 (UTC))

advance directive vs polst form

Added subsections to this section to make it clearer for the reader to see the differences between the advance directive and the polst form. Expanded on the info on the advance directive and polst form (P. Lee UCSF (talk) 21:37, 31 July 2020 (UTC))

oppositions

Showing both sides of the argument of the POLST form to make sure that the article remains neutral. (P. Lee UCSF (talk) 21:24, 31 July 2020 (UTC))

What is on the POLST Form

Expanded and went more into detail of what is exactly on the POLST form (P. Lee UCSF (talk) 18:59, 30 July 2020 (UTC))

POV tag

I have removed the POV tag for the moment. I am interested in improving this article, so by removing the tag and adhering the the bold, revert, discuss cycle I hope to get a better sense of what specifically can be addressed in terms of POV. I recently did a bit of editing here, and did not encounter any assertions from reliable sources that the POLST was controversial at all. If anyone is able to point me in the right direction I would be happy to replace some of that material. -- [ UseTheCommandLine ~/talk ]# ▄ 08:11, 11 August 2013 (UTC)

POLST beyond merely controversial; described as "lightning rod"

The recent story in USA Today, New form adds some teeth to end-of-life care preferences notes that "the form has faced controversy" and lists objections from disability-rights, Catholic, and other sources. The Milwaukee Journal-Sentinel also reports that "End-of-life medical care initiative prompts worries about abuse" and quotes the chief medical officer of the Wisconsin Medical Society as saying, "POLST is the lightning rod at the moment." This needs a major re-write to conform with WP:NPOV and not read as a promotion of POLST. 72.221.97.129 (talk) 23:12, 11 August 2013 (UTC)

One person's description does not automatically make something "beyond merely controversial". At the same time, I agree that it does need some cleanup. While much of it is well sourced from a MEDRS perspective, the section on future goals stands out to me as being inappropriate as currently composed.

I also note that I was unable to find substantial criticism of the POLST in the medical literature on the same grounds as the Catholic organizations. In fact, the medical literature seems to be almost uniformly positive in tone. For this reason, I think it would be best to stake out specific sections of the article for the different types of sourcing that will be used.

For instance, this opposition you speak of seems to be coming mainly from religious sources. That would seem to demand a separate section about the cultural effects of the POLST initiative. While I'm not too familiar with the legal literature, I imagine there might need to be a section on the legal aspects of the POLST, including any legal challenges that have been mounted to it.

I think, though, that if we can segment it like this, and maintain these limitations on scope based on our sourcing, then we will be able to improve the article a lot more readily and quickly.

Interested in your thoughts or responses. -- [ UseTheCommandLine ~/talk ]# ▄ 00:01, 12 August 2013 (UTC)

Obviously controversial/non-neutral

I added the "Controversial" tag above and a "Controversies" section in the article. If editors can't even agree whether the article/subject is controversial (and have relevant sources), then it is controversial by definition. Virtually all the sources in the reference list are from the same group of authors who are funded for their POLST innovations--hardly neutral. Also, I was able to find disputation and criticism of POLSTs in the medical community simply by following the first source and checking the related articles section. It took me almost as little time to find attorney, legislative, and religious critiques or questions with a search engine. I have started adding these in a comment below the "Controversies" section I added and will continue to add more, placing them inline as I wade through the voluminous literature. I've also included some links from the Talk Page and some other web sources that may be less credible unless I find corroboration. It only took ten minutes to find reputable sources indicating controversy, it'll probably take 20 times that to distill them into a concise and readable section improving this article. If you can't find references yourself, please use the partial list I've added to help make this a well-rounded article instead of a promotion by a couple doctors who make their living off POLST. But more legal references would certainly help, because most of the cases and analysis I can find are behind pay walls and therefore not terribly useful here.

External Links

http://www.speedytemplate.com/polst-template.asp is not actually a link to a template. E Hassen (talk) 01:42, 12 December 2015 (UTC)

Both links were removed as spam. E Hassen (talk) 01:44, 12 December 2015 (UTC)

External links modified

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Foundations II Peer Review

. 67.188.208.19 (talk) 20:40, 3 August 2020 (UTC)

Suggestions: I would suggest to make a separate section for how well a POLST form is followed by providers instead of putting a sentence on it at the end of each POLST section you discussed. This might make the article a little more easy to read. The section "How is the form used" can be enhanced by adding context of when the form is used (specific disease states to provide an example) in the beginning since the rest of the paragraphs talks about the process of filling out this form. A timeline of events might be helpful to clarify the importance of this section. Or maybe renaming the section could clarify the importance of this section. There is no evidence of plagiarism or copyright issues with the edits. CSaeteurn, Future UCSF PharmD (talk) 21:26, 3 August 2020 (UTC)

Wiki Goals:The group’s edits contributed more information about what is on a POLST form and describes each section more into detail by breaking it into other sub-headings. (Example: “What is on the POLST Form?” and “Cardiopulmonary resuscitation (CPR)”) In addition, the group expanded more into how the POLST form is used as well as how it is different from an advance directive. To make the article neutral they provided public opinions for support, as well as opposition for the use of the form within the healthcare setting. Overall, the group has achieved the goals discussed for improvement of the article! They did a great job in finding more information about the POLST form and adding it into the Wiki. However, there are areas of improvement within the format to be consistent with Wikipedia’s manual of style. SntnPhung (talk) 21:14, 3 August 2020 (UTC)

Guiding Framework:According to the Guiding Framework peer review guide, the audience for Wikipedia is for the general public, and terms such as “cases” or “patients” should not be used. In the POLST wikipage, under the “What is on the POLST Form?” section, phrases such as “The POLST form generally has sections for the patient…”, “…contains options for the patient…”, or etc. should be changed to reflect a more general audience. Under the “Advance Directive” sub-heading, the use of the word “you” is utilized a lot, and should be changed. For example, the sentence “An advance directive is a legal document that allows you…” should be changed to “An advance directive is a legal document that allows for persons to share their preferences with the health care team if the person is unable to speak for themselves.” Overall, there are multiple sections that should be improved to reflect a more general audience. Phrases including the words “patient” or “you” should be changed. SntnPhung (talk) 21:13, 3 August 2020 (UTC)

Wiki Goals:All of the goals listed by the group on the talk page were either started or completed, for example the sections on opposition, limitations to research, and expansion of the history section were all added to the article. One piece of feedback for this is that the instructions for posting goals to the talk page could have been followed so that they were clearly under a section heading of "Foundations II" so they can be more easily found. Cmueller6267 (talk) 21:17, 3 August 2020 (UTC)

Sources/Citations:Regarding citation of sources, there are several sentences under the section "Preferred Medical Interventions" and the following sections that do not have sources cited at the end of the sentence, so it is unclear where this information came from. There should be a citation at the end of every sentence, just so it is clear that this information came from somewhere. I believe even if several sentences are using information from the same source, that each sentence should still have its own citation (based on what I have seen on other reputable Wiki articles). Cmueller6267 (talk) 21:17, 3 August 2020 (UTC)

Suggestions:A suggestion for the subsections under the "What is on the POLST Form?" section is to move all of the sentences at the end of those sections that say "A study showed..." into their own section to make it flow better. Cmueller6267 (talk) 21:16, 3 August 2020 (UTC)

Suggestions:The additions to the article add important information on the format of POLST document and what decisions it can dictate for a person during end of life care. I believe the group has achieved their overall goals of adding more context and detail to the article. In terms of more specific critiques I would recommend defining acronyms (such as DNI and DNR in the introduction). I would also give context when citing "one study," by saying that there is not a lot of evidence besides the one study to support a certain conclusion. Lastly, in line with Wikipedia’s manual of style for medicine related articles, I would rephrase sentences with the word “patient” to better address the audience. In terms of point of view, the article is written in a neutral manner. However, the public opinion section of POLST has more information/evidence on the support side than the opposition side which can come off unbalanced in terms of point of view.DLPHAN (talk) 21:23, 3 August 2020 (UTC)