Medical Orders for Life Sustaining Treatment - Patients & Families
Goals of the MOLST Program
The goals of the Medical Orders for Life-Sustaining Treatment (MOLST) Program are consistent with the two key goals of palliative care: to improve the quality of life and to reduce suffering of patients with serious health conditions.
MOLST is a New York State Department of Health (NYSDOH) medical order form (DOH-5003) that tells others the patient's wishes for life-sustaining treatment. MOLST is approved for use in all settings under NYS Public Health Law. All health care professionals must follow these medical orders as the patient moves from one location to another , unless a physician examines the patient, reviews the orders and changes them.
The MOLST Program was designed to:
- Document medical orders for life-sustaining treatment:
- Resuscitation instructions when the patient has no pulse and/or is not breathing: A choice between (CPR) Order: Attempt Cardio-pulmonary Resuscitation or a DNR Order: Do Not Attempt Resuscitation and Allow Natural Death
- Orders for other life-sustaining treatment and future hospitalization when the patient has a pulse and the patient is breathing
- Treatment guidelines
- Instructions for intubation and mechanical ventilation
- Future hospitalization/transfer
- Artificially administered fluids and nutrition
- Antibiotics
- Other instructions
- Ensure medical orders are based on the patient's current medical condition, values, beliefs, wishes and goals for care.
- If the patient is unable to make medical decisions, the medical orders should reflect patient wishes, as best understood by the health care agent or surrogate.
- Communicate a patient’s wishes regarding care across health care and community settings.
- Improve Emergency Medical Services (EMS) personnel’s ability to treat the patient according to the patient’s wishes.
- Reduce repetitive documentation while complying with New York State law and the Federal Patient Self-Determination Act.
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