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Rebuttal to Jason Manne re Dangerous Catholic Attack on POLST

This is a brief rebuttal to Jason Manne’s recent response to my post “ Dangerous Catholic Attack on POLST .”

Manne’s letter misses the point. First, POLST is not just a form but also a process and conversation. And POLST is continually improving: (1) through conducting a range of research projects to determine best practices, (2) through enhancing education, and (3) through quality assessment. POLST Paradigm continues to work toward better patient-centered care by encouraging advance care planning conversations, for those nearing the end of their lives, to ensure that clinicians honor both patient wishes to receive and patient wishes to limit treatment. POLST

Second, Manne also understates the amount and quality of research that has been conducted. The National Quality Forum identified the POLST Program as a recommended preferred practice. And numerous articles and commentators have recommended the POLST program as a successful innovation to improve advance care planning implementation. There are now over a dozen data-based studies on POLST in the literature covering many aspects of POLST, including use in the community, by EMS, in hospice, and in long-term care. These studies have all been published in peer-reviewed journals, reflecting their evaluation by independent scientists prior to publication. Moreover, the POLST “Quality and Research Toolkit” contains 29 instruments and is available for state coalitions to expand their own quality assurance programs. Both these instruments and links to published research are available at

Third, Manne wrongly characterizes my argument as alleging that Catholics are dangerous and that Catholic objections are dangerous. I did not state or defend either. As the title of my original post itself suggests, what I consider “dangerous” is the conclusion and verdict that Catholics have drawn from their objections: wholly abandon POLST.

In contrast to the Catholics, by contending that POLST advocates must “deal with” Catholic objections to POLST, Manne at least appears committed to the project of continued assessment and quality improvement. Manne has espoused this objective in the mission statement of his blog. I commend him for remaining engaged with the Millian-like program of ongoing discussion and development. What is alarming and “dangerous” about the Catholics is their wholesale surrender and relinquishment of an effective and still-improving POLST.

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