You may have heard about a new kind of health care directive in New York, called a Medical Orders for Life-Sustaining Treatment (MOLST) form. Here, we discuss what a MOLST form is and when you might need one.
A MOLST 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 MOLST form may be used in addition to -- or, sometimes, instead of -- a DNR order. The MOLST form may also provide other information about your wishes for end-of-life health care, as explained below.
A health care professional can help you create a MOLST 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 MOLST form, you may ask for one.
To be legally valid, a MOLST form must be signed by:
In New York, a MOLST 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.
A MOLST form differs from a DNR order in one important way: A MOLST form also includes directions about life-sustaining measures in addition to CPR, such as intubation, antibiotic use, and feeding tubes. The MOLST 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 proxy.
Taken together, a living will and health care proxy can provide more information than a MOLST form, including details about your health care agent, more complete health care wishes, and your preference for organ donation.
You need to consider a MOLST only if you're facing a life-threatening medical condition. If you're healthy, you need only a living will and health care proxy 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 MOLST in addition to traditional health care directives. That’s because a living will and medical power of attorney 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 MOLST or DNR form. 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 MOLST in addition to traditional health care directives.
For more information about making health care directives, see New York Living Wills and Health Care Proxies: What You Need to Know.
For general information about how to document your health care wishes, see the Living Wills & Medical Powers of Attorney section of Nolo.com.
For more on New York estate planning issues, see our section on New York Estate Planning.