Even if your state does not (yet) have a POLST option, consider documenting your preferences using other forms, like a living will, durable power of attorney for health care, and the like.

The barriers to effective advance care planning are numerous. It is imperative that we, as patients, health care providers and members of society, overcome these barriers and remain active in pursuing our personal values and goals.

Sadly, informed consent and shared decision-making, the twin pillars of patient-centered health care, aren't the rock-solid structures we would hope for. That's the lesson of a new study in the Journal of Intensive Care Medicine.

How do we get doctors to honor our wishes at the end of life? Most recommend preparing an advance directive, and I'm no exception. These documents are not infallible, but they are the best things we've got going for us when we can't speak for ourselves.