You may have heard about a new kind of health care directive in Rhode Island, 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 Rhode Island, 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 durable power of attorney for health care.
Taken together, a living will and a durable power of attorney for health care 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 power of attorney 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 health care 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. 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 Rhode Island Living Wills and Durable Powers of Attorney for Health Care: 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.