You may have heard about a new kind of health care directive in Vermont, called a Clinician Orders for Life-Sustaining Treatment (COLST) form. Here, we discuss what a COLST form is and when you might need one.
What Is a COLST Form?
A COLST form is a doctor’s order that helps you keep control over medical care at the end of life. Like a Do Not Resuscitate (DNR) order, the form tells emergency medical personnel and other health care providers whether or not to administer cardiopulmonary resuscitation (CPR) in the event of a medical emergency. The COLST form replaced Vermont’s former DNR order as of July 1, 2011. DNR orders signed before July 1, 2011 are still valid.
The COLST form may also provide other information about your wishes for end-of-life health care, as explained just below.
How to Make a COLST Form
A health care professional can help you create a COLST form if you enter a medical facility or health care setting -- such as a hospital, nursing home, or hospice care in a facility or at home. To be legally valid, a COLST form must be signed by a qualified health care clinician, such a physician, physician assistant, or advance practice registered nurse. (18 Vermont Statutes § 9701(4).) If a member of the medical staff does not ask you whether you want to create a COLST form, you may ask for one.
A COLST form may be printed on brightly colored paper so it will easily stand out in your medical records. The form travels with you if you move from one health care setting to another. You can change it or cancel it at any time.
How Does a COLST Form Differ From Other Health Care Directives?
A COLST form differs from a DNR order in one important way: A COLST form also includes directions about life-sustaining measures in addition to CPR, such as intubation, antibiotic use, and feeding tubes. The COLST form helps medical providers understand your wishes at a glance, but it is not a substitute for a properly prepared Advance Directive.
An Advance Directive provides more information than a COLST form, including details about your health care agent, more complete health care wishes, and your preference for organ donation. Therefore, if you have a COLST form, you do not need a DNR order, but you should still complete an Advance Directive to provide a full set of wishes about your care.
For details about preparing health care directives in Vermont, see Vermont Living Wills and Advance Directives: What You Need to Know.
For More Information
For general information about how to document your health care wishes, see the Living Wills & Medical Powers of Attorney section of Nolo.com.