“The problems relating to the TEXAS SENATE BILL 303 are manifestations of the “third path” euthanasia movement which have been financed by private foundations for nearly three decades — i.e. the Robert Wood Johnson Foundation in the mid-80s forward and George Soros in the mid-90s forward to now.

The “third path” is the more subtle wing of the euthanasia movement. The introduction to LifeTree’s timeline at helps to compare and contrast the two wings of the euthanasia movement — the radical vs the low profile groups.

Obama’s healthcare reform bill is the culmination of three decades of low profile strategies to legalize euthanasia.

Unfortunately, the fundamental change in End Of Life care began with the seemingly innocent introduction of a new field in medicine called palliative medicine in the mid 80s. The trick was to position palliative medicine as the moral alternative to physician assisted suicide by various pieces of legislation starting in 1997 with Quill v Vacco, etc.

The true definition of palliative care is much more than simple pain and symptom management. It is a process, a philosophy, whereby carefully trained and certified palliative professionals (physicians, nurses, social workers, chaplains, etc) work within the family dynamic with the goal of bringing about a “consensus” decision to switch from curative to comfort care only. Their goal is to move palliative care “upstream” to the time of diagnosis. Hospice is a subset of palliative medicine.


MOST = Medical Orders for Scope of Treatment
POST  =  Physician Orders for Scope of Treatment
MOLST = Medical Orders for Life Sustaining Treatment
POLST = Physician Orders for Life Sustaining Treatment

TPOPP = Transportable Physician Orders for Patient Preferences

The POLST paradigm (POLST/MOST/POST/MOLST/TPOPP form) is one of their important tools and a means by which they are able to have the futility decisions in Texas which have caused so much publicity actually come from what one could characterize as a quiet, friendly patient- family- oriented process. POLST gives legal cover for hastening death, just as does Texas End-of-Life legislation. (And yes, the proposed revisions to Texas law contained in Senate Bill 303 contains nothing to write home about.)

POLST originated in Oregon in the mid-90s and has spread to the majority of states and some countries. (There are POLST forms in Spanish, Japanese, French etc). For more history, one can google LifeTree’s website ( for “POLST.”

We in North Carolina were presented with the POLSTparadigm some 8 years ago after the POLST paradigm had been studied using pilot programs in various parts of the state. By invitation, because LifeTree was considered a “stateholder”, we attended an organizational meeting in March, 2005 sponsored by the NC Medical Society which gave us a better understanding of the true nature of POLST. Immediately, we saw the need to warn about POLST (see our e-newsletters).

Wisconsin and Minnesota Catholic bishops have recently expressed their opposition to POLST, but other Catholic bishops sought to modify the form to make it “acceptable.” Unfortunately, no tweaking of POLST can adequately protect human life.

POLST is a form that contains a series of checked boxes to direct medical treatment in advance of actual health circumstances. The categories include use of antibiotics, intravenous fluids, transportation to the hospital, ventilators, etc.. Upon signatures (neither the patient nor the doctor must sign in some states) POLST immediately becomes doctor’s orders and is easily noticed on bright colored (usually hot pink) paper.

What actually happens is that POLST is filled out by a patient (or a patient’s representative) with the help of a POLST facilitator (NOT THE PATIENT’S PHYSICIAN). Contrary to the reports that POLST is patient-centered, POLST actually removes the doctor-patient relationship and replaces it with a FACILITATOR-patient (or FACILITATOR- patient representative) relationship. In some states, POLST actually trumps a health care power of attorney!

Both the radicals and the low profilers support POLST. Their eventual goal is to require electronically recorded POLST forms for everybody. Many nursing homes now require that POLST forms be filled out as part of the admission process.

Here is a notice of an upcoming FACILITATOR education training session in New Hampshire .!/05292013%20POLST%20Trng%20PClary.pdf?item_id=207819082&version_id=207819083.

Does the following sentence not give away their true intentions?

“Without an emphasis on the importance of American College of Physicians’ discussions and qualified facilitators, implementation of the POLST form runs the risk of repeating the failures of past standard Advance Directives efforts that have focused only on form completion.”

So the Texas Senate Bill 303  will become obsolete if the Right-to-Die groups get their way. POLST will be part of every person’s electronic healthcare records filled out with the help of a carefully-trained facilitator.”

Elizabeth (Betty) D. Wickham, PhD

About abyssum

I am a retired Roman Catholic Bishop, Bishop Emeritus of Corpus Christi, Texas
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