You may have heard about a new kind of health care directive in Colorado, called a Medical Orders for Scope of Treatment (MOST) form. Here, we discuss what a MOST form is and when you might need one.
A MOST form is a doctor’s order that helps you keep control over medical care at the end of life. Like a Colorado CPR Directive, 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 instead of -- a CPR Directive. The MOST form may also provide other information about your wishes for end-of-life health care.
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. If a member of the medical staff does not ask you whether you want to create a MOST form, you may ask for one.
To be legally valid, a MOST form must be signed by:
In Colorado, a MOST form is usually printed on bright green 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.
A MOST form differs from a CPR Directive 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 advance health care directive.
An advance directive provides more information than a MOST form, including details about your health care agent, more complete health care instructions, and your preference for organ donation. Therefore, if you have a MOST form, you do not need a CPR Directive, but you should still complete an advance directive to provide a full set of wishes about your care.
You need to consider a MOST only if you're facing a life-threatening medical condition. If you're healthy, you need only an advance directive to provide a full set of wishes for your treatment in the event of an unexpected accident or medical crisis.
On the other hand, a patient diagnosed with a terminal illness or frailty that requires care in a medical setting -- or ongoing care at home -- may need a MOST in addition to traditional health care directives. That’s because an advance directive may not be enough to prevent medical personnel from resuscitating a patient in an emergency. For that, it's important to have a medical order such as a MOST or CPR Directive. If you feel strongly that you don’t want emergency measures at the end of life -- or if you’re caring for someone who feels that way -- find out about making a MOST in addition to traditional health care directives.
For details about making an advance directive in Colorado, see Colorado Living Wills and Medical Durable Powers of Attorney: What You Need to Know.
To learn more, and to view an example of the Colorado MOST form, visit the Colorado Advance Directives Consortium website. To prepare a MOST form for yourself or a loved one, talk to your health care provider.
For more on Colorado estate planning issues, see our section on Colorado Estate Planning.