Medical Order for Life-Sustaining Treatments

Medical Orders for Life-Sustaining Treatment (MOLST) forms are medical directives signed by a doctor and used to convey a patient's wishes regarding life-sustaining treatment. The purpose is to improve the quality of care that seriously ill people receive at the end of life.

The form does not replace a Health Care Proxy and Living Will which are completed in advance and apply only when you can't speak for yourself. In a Health Care Proxy, you appoint an agent to make medical decisions for you if you no longer can. In a Living Will, you state your wishes regarding life-sustaining treatment.

By contrast, a MOLST form is only for the seriously ill, applies in the present and contains medical orders based on the patient's wishes after discussions with a doctor.

A survey by BlueCross revealed only 42% of those surveyed had chosen a health care proxy, so most people are without an advance directive for medical decisions. The Family Health Care Decisions Act allows a close family member or friend to make health care decisions for incapacitated loved ones who do not have a health care agent or didn't previously make such decisions.

The Family Health Care Decisions Act designates, in order of priority, who can act as a surrogate for the adult incapacitated person. The first surrogate is the spouse or domestic partner. The list then includes adult child, parent, sibling, and last, a close friend. If the court has appointed a legal guardian, that person takes priority.

Decisions are based on the patient's wishes or the patient's best interests if the patient's wishes are unknown. The MOLST form and The Family Health Care Decisions Act are advancements in honoring each person's end of life desires regarding medical treatment.

However, it can't be stressed enough - the best way to honor one's desires regarding end of life medical treatment is to complete a Health Care Proxy and Living Will in advance.