POLST - DNAR without Consent

I strongly support POLST.  I have been actively engaged with its implementation in both Delaware and Minnesota.  And I am presently preparing a lengthy report to aid the continuing nationwide roll-out.  

But I was surprised to see that some POLST programs and forms explicitly permit unilateral clinician orders.  This form from Vermont, for example, permits the clinician to complete a DNAR order on a patient's POLST without either patient or surrogate consent, in the case of "futility."  

I am not saying that I am necessarily opposed to this development.  Many states have taken the opportunity, when introducing new statutes and regulations authorizing POLST, to fix some other limitations and problems in health care decisions law.  I was simply surprised, because so much of the defense of POLST, in response to attacks from certain Catholic officials, focuses so heavily on its voluntary nature.