A POLST form ("physician orders for life-sustaining therapy" form) specifies:

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POLST forms (used in more than half of all states in the United States) are the expressed wishes of a patient about end-of-life care with respect to cardiopulmonary resuscitation, the use of intravenous fluids and antibiotics, and the provision of nutritional support (e.g., through feeding tubes). They are completed by patients and cosigned by health care providers. They do not designate the physician as the surrogate decision maker for the patient, and they have no references to mortuaries, organ donation, or other postmortem concerns.

A POLST Form ("Physician Orders for Life-Sustaining Therapy" Form) Specifies