Utah POLST Form: Decisions Recorded, Signatures, and Scope

The Utah POLST form, now officially called an Order for Life-Sustaining Treatment (OLST), is a medical order signed by a doctor and patient that tells paramedics and hospital staff exactly which life-sustaining treatments the patient does and does not want. Because it is a physician’s order, emergency responders can act on it immediately, the same way they would act on any other order in a chart. The current governing statute is Utah Code 26B-2-802, and while the legislature renamed the document, most providers and websites still call it a POLST. The function is identical under either name.¹

Who the Form Is For

A POLST is not a general-purpose planning document. It is designed for people with serious, life-limiting illness where decisions about CPR, ventilators, and feeding tubes are likely to come up soon. Clinicians use the “surprise question” to identify appropriate candidates: would the patient’s doctor be surprised if this person died within the next year? If the honest answer is no, a POLST conversation makes sense.² Late-stage cancer, advanced heart failure, progressive neurological disease, and advanced frailty in older adults are typical situations.

If your health is generally good and end-of-life questions feel distant, a standard advance directive is the right document instead. Utah law sets no minimum age for a POLST, and a parent or guardian can obtain one for a minor with a life-threatening condition. When the form directs that treatment be withheld or withdrawn from a child, two physicians must independently certify that the order is in the minor’s best interest.³

What Decisions the Form Records

The Utah OLST is divided into four sections, and you check one box per section. There is no free text, no room for interpretation in the moment.⁴

Section A covers CPR. If the patient has no pulse and is not breathing, responders either attempt resuscitation or allow natural death. Choosing “Do Not Resuscitate” means no chest compressions and no defibrillator use. If you select DNR in Section A, ask your provider about an official DNR bracelet or necklace. Utah law recognizes the bracelet as valid evidence of the order, and EMS protocols direct paramedics to honor a DNR bracelet or necklace from any U.S. state.³

Section B covers medical interventions when the patient has a pulse but needs treatment. Options range from full treatment (including intubation, mechanical ventilation, and ICU care), to limited interventions (IV fluids and medications, but no ventilator), to comfort measures only (pain relief and basic hygiene, with hospital transfer only if comfort cannot be managed where the patient is).

Section C covers artificial nutrition: long-term tube feeding, a trial period of tube feeding, or none at all.

Section D coordinates the OLST with any separate advance directive, names a healthcare agent if one has been appointed, and records whether the patient wants the OLST followed strictly or treated as a general guide that a surrogate can adjust if circumstances change.

One rule ties Sections A and B together. If you select “attempt to resuscitate” in Section A, you must also select “full treatment” in Section B. Choosing DNR in Section A, on the other hand, is compatible with any level of intervention in Section B.

Who Signs, and How

A POLST must be prepared by a physician, advanced practice registered nurse, or physician assistant in consultation with the patient or their authorized representative. A nurse, mental health professional, or other designated provider can prepare the form, but only under the supervision of one of those three qualifying providers.³

Two signatures make the form legally valid. The qualifying medical provider (MD, DO, PA, or APRN) must sign personally, and the patient must also sign. A patient who prefers can direct another adult to sign on their behalf.⁵

When a patient lacks decision-making capacity, a surrogate signs instead. Utah’s priority order under Section 75A-9-111 generally starts with a healthcare agent named in an advance directive, then a court-appointed guardian, spouse, adult children, and so on. When several people share the top priority, such as multiple adult children, a majority of that group must agree.³

If requiring a surrogate’s in-person or electronic signature would cause significant difficulty or expense, a verbal confirmation satisfies the signature requirement, provided a licensed healthcare provider witnesses the verbal consent and signs the form attesting to it.³

How a POLST Differs from an Advance Directive

People often confuse these two documents, and the confusion has real consequences. An advance directive (a living will, a healthcare power of attorney, or both) is a set of instructions you write while healthy that takes effect only when you lose the ability to make decisions. A POLST is a set of medical orders you write with your doctor that takes effect right now.

The difference is clearest in an emergency. When paramedics arrive, they follow standing medical orders. A POLST is a standing order. A living will in a filing cabinet is not, and even if a family member produces one, paramedics generally cannot interpret or act on it. That gap is exactly what the POLST fills.

The two documents are complementary. An advance directive covers the full range of future healthcare decisions and names someone to make choices for you; a POLST narrows the focus to specific life-sustaining treatments and converts those preferences into orders. If a POLST and a separate advance directive conflict on the same issue, the POLST controls, since it typically reflects the more recent conversation between patient and provider.⁶ Most people who have a POLST should also have an advance directive, and Section D of the OLST is designed specifically to document how the two relate.

Extra Rules for Minors and Pregnancy

Two situations carry additional legal requirements worth flagging.

For minors, a parent or guardian signs the OLST, but when the form directs that life-sustaining treatment be withheld or withdrawn, two physicians must independently certify that the order is in the child’s best interest. A single physician’s recommendation is not enough.³

For pregnant patients, an advance directive that calls for withholding or withdrawing life-sustaining treatment has no legal force during the pregnancy. The restriction applies to the advance directive specifically and does not undo the appointment of a healthcare agent, who can still make other medical decisions.⁷

Bringing a POLST from Another State

If you move to Utah or travel here with a POLST from another state, Utah’s administrative rules provide that the out-of-state form may be honored as if executed in Utah, so long as it is substantially similar to Utah’s OLST and was completed according to the laws of the originating state.⁸ Utah EMS protocols go further and direct paramedics to honor a signed POLST from any U.S. state that indicates the patient does not want resuscitation.

“May be honored” is not “must be honored.” If you are relocating to Utah permanently or spending significant time here, the safest course is to complete a new Utah OLST with a local provider.

Changing or Canceling the Form

You can cancel or change your POLST at any time. Utah law gives you several ways to revoke an OLST, and the variety reflects the reality that people in medical crises do not always have a pen or a fresh form on hand:³

Tell emergency responders or state in front of an adult witness that you want the order revoked.
Write “void” across the form, or tear, burn, or otherwise destroy it, including any bracelet or necklace linked to the order.
Ask another adult to void, destroy, or sign a written revocation on your behalf.
Complete a new OLST, which automatically replaces the old one.

A parent or guardian can revoke a minor’s OLST using the same methods. Any revocation should be documented in the patient’s medical record as soon as possible so an outdated form does not surface later and cause confusion. Updating rather than revoking still requires the full completion process, meaning consultation with a qualifying provider and both signatures.

1
Utah Legislature. H.B. 200 Order for Life Sustaining Treatment Amendments
2
HealthIT.gov. Electronic End-of-Life and Physician Orders for Life-Sustaining Treatment (POLST) Documentation Access through Health Information Exchange
3
Utah Legislature. Utah Code 26B-2-802 – Order for Life Sustaining Treatment
4
Utah Department of Health & Human Services. Order for Life-Sustaining Treatment (OLST)
5
Utah Division of Licensing and Background Checks. R432-31 Order for Life-Sustaining Treatment Checklist
6
Utah Legislature. Utah Code 75-2a-106 – Emergency Medical Services – POLST Order
7
Utah Legislature. Utah Code 75-2a-123 – Pregnancy
8
Utah Division of Administrative Rules. Utah Administrative Rule R432-31 – Transferable Physician Order for Life-Sustaining Treatment