Authors' Response to Jimenez et al. (doi: 10.1089/jpm.2019.0181) Re: Variations in Physician Orders for Life-Sustaining Treatment Program across the Nation: Environmental Scan (doi: 10.1089/jpm.2018.0626)

Dear Editor:

Thank you for your interest in our article.¹ The statement “the variation we observed make interstate transfer of POLST orders unlikely” was made based on three facts: (1) the lack of a centralized Physician Orders for Life-Sustaining Treatment (POLST) registry in the majority of U.S. states² (2) the variations in POLST forms including different requirements for patient signature and POLST form validity (i.e., signature not needed for Oregon POLST form, whereas it is a required for Washington POLST),^3,4 and (3) the recommendations to bring a hard copy when traveling out of state.⁵

We appreciate your perspective and experience with POLST and interstate transfers across the northwestern region. We are happy to learn that you have not encountered incidents where Oregon POLST forms were not respected by professionals in bordering states (i.e., Washington, Idaho, and California). As you note, your experience may be unique and we look forward to seeing more evidence of the transferability of POLST across states.

Nevertheless, there is more work to be done to ensure patient wishes are discussed, documented, and made aware.