NJ POLST vs. Living Will: Which Healthcare Directive Do You Need?
In New Jersey, a Living Will provides broad instructions for future healthcare, while a POLST is a set of immediate, actionable medical orders for emergency responders. Most healthy adults need a Living Will, whereas terminally ill patients require a POLST.
When planning for the end of life, the legal terminology can be overwhelming. In New Jersey, the right to dictate your own medical care-even when you can no longer speak for yourself-is a deeply protected right. However, patients and their families frequently confuse a traditional Advance Directive (often called a Living Will) with a newer, more urgent document known as a POLST (Practitioner Orders for Life-Sustaining Treatment).
Choosing the wrong document, or failing to have both when necessary, can result in emergency responders administering painful, unwanted medical treatments against your wishes. Understanding how these two legal instruments function under New Jersey law is the most important step you can take to ensure you pass away with dignity, on your own terms. We will break down exactly how they differ, who needs which document, and how they interact in a medical emergency.
The Fundamental Differences in NJ Law
New Jersey was a pioneer in patient rights, dating back to the landmark case In re Quinlan, 70 N.J. 10 (NJ Supreme Court 1976), which cemented a patient's constitutional right to refuse life-sustaining treatment. Today, that right is exercised through two distinct legal frameworks.
A Living Will is governed by the New Jersey Advance Directives for Health Care Act, N.J.S.A. § 26:2H-57. It is a legal document you draft with a lawyer that outlines your general wishes for future care (like refusing a ventilator) and appoints a healthcare proxy. A POLST, on the other hand, is governed by N.J.S.A. § 26:2H-131. It is an actual medical order, signed by a doctor, advanced practice nurse, or physician assistant. While a Living Will tells your family what you want, a POLST commands paramedics on exactly what to do right now.
Scenarios: Which Document Do You Need?
Your current medical condition dictates which document is most appropriate for you. Whether you are living in Edison, New Brunswick, or Cherry Hill, the application of these documents is universally respected by healthcare providers.
Healthy Adults (The Living Will)
If you are a healthy adult in your 30s, 40s, or 50s, you need an Advance Directive (Living Will). You do not need a POLST. An Advance Directive prepares you for unforeseen tragedies, such as a severe car accident that leaves you in a coma. By filling out Form Unnumbered, New Jersey, Department of Health, Proxy Directive and Instruction Directive, you name a trusted person to make decisions for you only if you become incapacitated.
Terminal Patients and the Elderly (The POLST)
If you have been diagnosed with a terminal illness, advanced dementia, or are extremely frail, a Living Will is no longer enough. You need a POLST. You and your doctor will fill out the bright green Form Unnumbered, New Jersey, Department of Health, Practitioner Orders for Life-Sustaining Treatment. This document specifies exactly whether you want CPR, feeding tubes, or just comfort care (palliative care). Because it is a medical order, it is immediately active.
Emergency Responders' Obligations
Here is the most critical difference: If an ambulance is called to your home in New Jersey and your heart stops, EMTs are legally required to perform CPR. If your spouse waves a Living Will in their face, the EMTs cannot stop CPR. They must follow protocol. However, if your spouse hands them a bright green POLST form that says 'Do Not Resuscitate' (DNR), the EMTs are legally obligated to stop immediately. A POLST is the only document that stops emergency responders in the field.
How the Two Documents Interact in NJ Hospitals
If you are transported to a facility like Robert Wood Johnson University Hospital or another local center, both documents work together. The POLST dictates the immediate emergency response upon entry. Once you are stabilized, the doctors will consult your Living Will and speak to your healthcare proxy for long-term decisions, such as whether to keep you on a ventilator for weeks or transition you to hospice care. The policies overseen by the New Jersey Department of Health, Trenton mandate that hospitals honor both documents, but in a conflict regarding immediate treatment, the POLST overrides the Living Will.
Cost & Timeline for Creation
Securing your medical future is generally inexpensive and can be completed very quickly.
| Document Type | Estimated Cost in New Jersey | Timeline for Creation |
|---|---|---|
| NJ Advance Directive (Living Will) | $150 - $400 (if drafted by a lawyer) | 1 - 2 weeks |
| NJ POLST Form | $0 (Included in a doctor's visit) | Immediate (during appointment) |
| Registering with US Living Will Registry | $0 - $50 | Instant online |
Frequently Asked Questions (FAQ)
Does a POLST replace my Advance Directive?
No. A POLST complements your Advance Directive. The Advance Directive appoints someone to speak for you regarding broad medical decisions, while the POLST provides specific medical orders for emergency personnel.
Where should I keep my POLST form in my house?
In New Jersey, it is highly recommended to keep the bright green POLST form right on your refrigerator or pinned to the wall near your bed. EMTs are trained to look in these specific locations during an emergency.
Do I need a lawyer to get a POLST?
No. A POLST is a medical document, not a strictly legal one. It must be filled out and signed by your treating physician, an advanced practice nurse, or a physician assistant. You do not need an attorney for this specific form.
Can my healthcare proxy change my POLST orders?
Yes, if you lose mental capacity, the healthcare proxy you appointed in your Advance Directive can consult with your doctor to modify or void your POLST if your medical condition changes significantly.
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