Massachusetts Orders For Life-Sustaining Treatment (MOLST)
A new state initiative is being rolled out in 2014 to ensure that people of any age who have a life-threatening medical condition, illness or injury can make their own choices about end-of-life medical care.
Massachusetts Medical Orders for Life-Sustaining Treatment, or MOLST, are written instructions from a physician to other health care providers regarding a patient’s medical care. They outline the types of emergency medical treatments a patient wants, or does not want, to be administered to keep them alive near the end of their life. These forms, which are voluntary, can be used by a person of any age who has a serious medical condition from which they may not recover to ensure their own preferences are honored by all health care providers. Unlike written “final wishes” or a living will, MOLST forms carry greater authority and will be honored by Massachusetts medical facilities. They also differ from “Do Not Resuscitate” (DNR) orders by providing additional instructions regarding medical care. MOLST forms can be changed or voided at any time.
Nantucket Cottage Hospital and Palliative & Supportive Care of Nantucket (PASCON) are working to educate patients, clinicians and caregivers about the MOLST program. Anyone with an advanced illness or injury should start discussions about advance care planning with their clinicians. The MOLST forms, which are bright pink, are filled out by a patient and their clinician, and should be kept by the patient in a location that is easy to locate, such as a refrigerator or bedside table. They should also be carried with the patient outside their home.
What are life-sustaining treatments?
These are medical treatments used to restart a person’s heart or breathing if they stop, such as:
• Cardio pulmonary resuscitation (CPR), such as mouth-to-mouth breathing, forceful pressure or electric shock to the chest. Many health care providers are legally required to use CPR if a patient’s heart or breath stops, unless they have written orders with other instructions from a doctor, such as MOLST form.
• Intubation and Ventilation, when a tube is put down a person’s throat and attached to a machine that pumps air into and out of the person’s lungs.
MOLST forms will provide EMT’s, health care facilities and clinicians with specific medical orders regarding treatments that are to be used or not to be used to start a person’s heart or breathing in the event they stop.
If you have questions about MOLST and end-of-life care, please contact PASCON at 508-825-8325. Additional information about MOLST is available at www.molst-ma.org.