This white paper, prepared by a working group of the Catholic Medical Association, provides a commentary on a new type of end-of-life document called a POLST form (Physician Orders for Life-Sustaining Treatment) as well as on its model (or "paradigm") for implementation across the United States. After an introductory section reviewing the origin, goals, and standard defenses of the POLST paradigm and form, the paper offers a critical analysis of POLST, including an analysis of the risks that POLST poses to sound clinical and ethical decision-making. The paper ends with several recommendations to help Catholic healthcare professionals and institutions better address the challenges of end-of-life care with alternatives to POLST.
When the FDA labeled ulipristal acetate (UPA; Ella is the product sold in the United States by HRA Pharma) an “emergency contraceptive,” Catholic and pro-life leaders criticized the decision, identified Ella as an abortifacient, and agreed it should not be used by Catholic institutions and providers.1 Ron Hamel, senior ethicist for the Catholic Health Association, shared this conclusion. In 2014, however, Hamel ended a review article by stating, “If, however, the consensus is correct, then there would seem to be sufficient moral certitude at this time to make use of UPA in Catholic hospitals.” Below I question whether a relevant consensus exists and argue that the scientific evidence militates against, rather than in favor of, use of UPA/Ella by Catholic providers.
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