A Physician’s Guide to End-of-Life Decisions (MOLST)

The denial of death is one of the strongest of human defense mechanisms. In fact, there’s an entire book about it.  We don’t want to think about our end-of-life care wishes. (Although some have instructed, “Wave a martini in front of me — if I don’t respond, pull the plug.”) I don’t like to think about it any more than the next person. But I also don’t like to think about my family and doctors arguing over keeping me on a ventilator when I could have easily told them in advance what I want in that situation. In the past, the only option would be the use of an “advance directive” or health care proxy.  That’s still a good idea, but some might wish to also involve their doctors in the discussion. Another technique known as Medical Orders for Life-Sustaining Treatment (or MOLST) is becoming more popular. As a recent article in The Wall Street Journal makes clear, a growing number of states, including New York, are promoting MOLST to help guide physicians with a patient’s specific instructions.

New York is one of the more forward-thinking states in instituting the program known as Medical Orders for Life Sustaining Treatments (MOLST)

MOLST is different from other advance directives such as living wills and health care proxies because it is physician generated instead of client/patient generated.  A licensed physician must always sign the MOLST.  It is printed on bright pink paper so that hospitals and nursing homes cannot fail to notice it.

While the MOLST is a good addition to helping people get their wishes fulfilled, it is most often employed for the elderly who are in need of life-sustaining care.  It should not replace the health care proxy and living will you would create along with your wills and financial powers of attorney.

I found myself filling one of these out several years ago, when we had to check my mother into a nursing home.  Despite years of seeing gerontologists and living in an assisted living facility, this was the first time we’d been presented with the option of discussing the MOLST.

You may want to discuss this with your physician or elder law attorney so that you too can participate in your own decisions on your end-of-life care.

 

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