Medical Orders for Life-Sustaining Treatment - Professionals

Ethics Review Committee

Under the Family Health Care Decisions Act (FHCDA), hospitals and residential care facilities must establish or participate in an Ethics Review Committee (ERC).

The ERC must consider and respond to any health care matter presented to the committee by a person connected with the case.  The response may include:

• Providing advice on the ethical aspects of proposed health care.
• Making a recommendation about proposed health care.
• Providing assistance in resolving disputes about proposed health care.

Recommendations and advice by the ERC is advisory and nonbinding.  However, there are special requirements when surrogates make medical decisions under the FHCDA, based on "irreversible or incurable condition".

• Hospitals:  Withdrawing or withholding artificial nutrition and hydration in a hospital over the attending physician's objection  
  • If the attending physician objects to the order, the ERC (including a physician who is not directly responsible for the patient's care) or an appropriate court must determine that the medical order meets the required standards.
• Nursing Homes:  For Life-Sustaining Treatment orders other than DNR orders
  • The ERC, (including at least one physician who is not directly responsible for the patient's care) or an appropriate court must determine that the medical orders meet the required standards.
• Emancipated Minor Decisions: 
  • The ERC review is required to withhold or withdraw LST without the consent of parent or guardian.

Training

• Recorded Webinar, FHCDA and Ethics Review Committee Training, December 16, 2010
• PowerPoint, FHCDA and Ethics Review Committee Training [pps]

Policies & Procedures

• Blossom View Nursing Home - 2011
• Jewish Life Care - 2011

Key Resources

• Bomba, P. A., Morrissey, MB., Leven, D.C. (2011).  Key Role of Social Work in Effective Communication and Conflict Resolution Process:  Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and Shared Medical Decision Making at the End of Life.  Journal of Social Work in End-Of-Life & Palliative Care Vol. 7, Issue 1, 56 - 82.
• Family Health Care Decisions Act (FHCDA), §2994-m, §2994-n,  §2994-0

Questions and Answers (Q & A)

Please Contact Us to submit a question on the Ethics Review Committee