Physicians are encouraged to discuss and document patient preferences for end of life care decisions as part of a process called advanced planning. Proper documentation and effective communication of patients’ preferences are critical to assuring that their decisions will be honored; a key element in rendering quality patient centered care.
NYACP urges physicians to educate & empower patients regarding the importance of noting their end of life preferences by completing the proper documents. These include a living will, healthcare proxy, and in some circumstances, a MOLST (Medical Orders for Life Sustaining Treatment) form. As a general rule, the MOLST is intended for patients with serious health conditions who: 1. want to avoid or receive any or all life-sustaining treatment; 2. reside in a long-term care facility or require long-term care services; and/or 3. might die within the next year.
The MOLST form serves as a document that contains a patient’s wishes regarding resuscitation, comfort measures and medical interventions. The MOLST form is the only authorized document in New York State that can be used to convey non-hospital Do Not Resuscitate (DNR) and Do Not Intubate (DNI) orders. All health care professionals are required to comply with medical orders in the document.
Before filling out the form, a patient or his/her health care agent or surrogate must have a discussion with a qualified health care professional about the patient’s diagnosis and prognosis, values and wishes, and possible treatment options. The physician must sign the form after the patient completes it. Please remind your patients to retain the original MOLST form and a copy of the form should stay in the doctor’s office file or EMR. It is recommended that the form be printed in bright pulsar pink, heavy-stock paper to make it easier for EMS personnel to recognize the order.
Patients and Physicians can access a free copy of all three advanced directive planning forms on the New York State Department of Health’s web site at http://www.health.ny.gov/diseases/conditions/dementia/adv_care_planning.htm