In the 1990s, Susan Tolle helped create the POLST. Now she and Elizabeth Eckstrom want to change it. And personally, I think they're right. Times have changed, and the POLST has gained a clearer purpose, distinct from Advance Directives. POLST is for emergency situations. When does the EMS provider ever say, "Quick! Get the PEG tube kit! We need to insert a PEG tube stat." Never. Feeding tubes are a decision that can be discussed in advance and a preference recorded in an advance directive. But it's the odd one out on the POLST form - and more than the CPR preferences and Scope of Care sections, is the outlier. It's the most " list-based " approach to advance care planning - do you want a feeding tube? How about dialysis? An LVAD? In certain situations, with certain illnesses, these are fine questions to have. But in general for older adults, they make no sense. Advance care planning should be directed by goals and values, not