Medical Orders for Life-Sustaining Treatment - Professionals
Core Elements of the MOLST Program
The MOLST Program is based on communication between the patient/resident or surrogate (the Health Care Agent or proxy or legally designated decision-maker) and health care professionals that ensures informed medical decision-making.Medical orders derived from these conversations should be recorded on the MOLST form.
The MOLST form
- Contains actionable medical orders regarding life-sustaining treatments.
- Is recommended for individuals with an advanced chronic progressive illness or terminal illness or for anyone interested in further defining their end-of-life care wishes.
- May be used to limit medical interventions or clarify a request for all medically indicated treatments including cardiopulmonary resuscitation (CPR).
- Provides explicit direction about resuscitation status (“code status”) if the patient is pulseless and/or apneic (not breathing).
- Includes directions about other types of intervention that the patient may or may not want.
For example: Decisions about future hospitalizations, ICU care, antibiotics, artificial nutrition and hydration, intubation and mechanical ventilation.
- Is a bright pink color that is easily identified in case of emergency.
- Accompanies the patient as he or she is transferred home or to a new care settings (e.g., long-term care facility or hospital).
- Should be reviewed and renewed periodically, as required by New York State and Federal law and regulations, and/or if:
- The individual is transferred from one care setting or care level to another.
- There is a substantial change in the patient/resident health status (improvement or deterioration).
- The patient/resident treatment preferences change.
- The individual is transferred from one care setting or care level to another.
Additionally, the MOLST Program:
- Includes training of health care professionals about the goals of the program and use of the MOLST form.
- Features a plan for ongoing monitoring of the program and its implementation.
