Medical Orders for Life-Sustaining Treatment (MOLST)

Honoring an individual’s choices

 There are many ways to honor someone’s choices when it comes to End of Life. One of the most important is to have documents in place that clearly outline treatment choices. Today’s blog deals specifically with the MOLST form

 A MOLST form is a medical order that communicates the patient’s wishes and preferences about life sustaining treatment to his/ her health care providers. It is based on a person’s right to information with regard to the risks and benefits of life-sustaining treatment based upon their current condition, and to make informed choices to either accept or refuse life-sustaining treatment.

A MOLST is both a medical document and a personal care planning document. It must be signed by a clinician and the patient to be valid. Clinicians that have the authority to sign a MOLST form are physicians, nurse practitioners, and physicians’ assistants.

The MOLST form is intended for individuals facing a serious/ terminal illness.

The process is a fairly simple one:

• A clinician, patient, or patient advocate initiate a conversation about CPR and other life-sustaining treatments. They are given information regarding all the possible risks, benefits, and expected outcomes based upon their current health condition.
• The patient chooses what they do, and do not want for care.
• The patient and the clinician record the choices on the MOLST form. There are two sides of the form. The choice can be made to fill out just the front or both the front and back sides of the form.
• The clinician and the patient sign the form and it goes into effect immediately.
• The form stays with the patient, a copy is placed in the medical chart, and copies can be given to the family. The original MOLST form travels with the patient to any treatment setting
• Changes can be made to the form over time to reflect the individual current condition.
• Please keep in mind that if the patient is declared to lack the capacity to make health care decisions, the patients appointed health care agent has the authority to make medical care decisions and sign the MOLST form on his/her behalf. It is important to choose your health care agent carefully. The health care agent should have a clear understanding of your condition and have your best interests at heart.
• To learn more about MOLST forms go to: www.molst-ma.org