North Carolina's Medical Orders for Scope of Treatment (MOST) Form

A MOST form describes your wishes for health care in a medical emergency.

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You may have heard about a new kind of health care directive in New York, called a Medical Orders for Scope of Treatment (MOST) form. Here, we discuss what a MOST form is and when you might need one.

What Is a MOST Form?

A MOST form is a doctor’s order that helps you keep control over medical care at the end of life. Like a Do Not Resuscitate (DNR) order, the form tells emergency medical personnel and other health care providers whether or not to administer cardiopulmonary resuscitation (CPR) in the event of a medical emergency. A MOST form may be used in addition to -- or, sometimes, instead of -- a DNR order. The MOST form may also provide other information about your wishes for end-of-life health care, as explained below.

How to Make a MOST Form

A health care professional can help you create a MOST form if you enter a medical facility or health care setting -- such as a hospital, nursing home, or hospice care in a facility or at home. To be legally valid, a MOST form must be signed by a physician, physician’s assistant, or nurse practitioner. (North Carolina Statutes § 90-21.17.) If a member of the medical staff does not ask you whether you want to create a MOST form, you may ask for one.

In North Carolina, a MOST form is usually printed on bright pink paper so it will easily stand out in your medical records. The form travels with you if you move from one health care setting to another. You can change it or cancel it at any time.

How Does a MOST Form Differ From Other Health Care Directives?

A MOST form differs from a DNR order in one important way: A MOST form also includes directions about life-sustaining measures in addition to CPR, such as intubation, antibiotic use, and feeding tubes. The MOST form helps medical providers understand your wishes at a glance, but it is not a substitute for a properly prepared Living Will and Health Care Power of Attorney.

Taken together, a Living Will and a Health Care Power of Attorney can provide more information than a MOST form, including details about your health care agent, more complete health care wishes, and your preference for organ donation. Therefore, if you have a MOST form, you do not need a DNR order, but you should still complete these two important health care directives to provide a full set of wishes about your care.

For more information about making health care directives, see North Carolina Living Wills and Health Care Powers of Attorney: What You Need to Know.

For More Information

To learn more, and to view an example of the North Carolina MOST form, visit the website of the North Carolina Medical Society.

For general information about how to document your health care wishes, see the Living Wills & Medical Powers of Attorney section of Nolo.com.

 

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