You may have heard of DNRs and MOLST forms but not be certain about what they are or how they relate to health care proxies and advance directives. Here’s a short primer:
Health Care Proxies
You use a health care proxy to name the person you want to step in and make medical decisions for you when and if you become incapacitated and can no longer make such decisions.
Health Care Directives
Health care directives are instructions you write to guide your health care agent so they can know what choices you would make if you were not incapacitated. These can be broad statements of philosophy, such as your desire that no extraordinary measures be taken to keep you alive if you are no longer cognitively intact or specific instructions for what steps you would like taken to respond to specific diagnoses.
DNRs
In the absence of a Do Not Resuscitate (DNR) order from a medical professional, health care providers must do whatever they can to revive you if you experience a medical crisis, no matter your underlying health. A DNR can prevent a potentially violent resuscitation effort by being posted on a patient’s bed at a hospital or long-term care facility or prominently in the individual’s home. Unlike health care proxies and directives which are executed by the individual, DNRs are signed by medical professionals such as doctors and nurses.
MOLST
A Medical Orders for Life-Sustaining Treatment (MOLST) form, referred to as a Physician/Provider Order for Life-Sustaining Treatment (POLST) form in some places, goes further than a DNR in covering types of care beyond resuscitation, including hydration, artificial nutrition, ventilation, and whether to transfer the patient to a hospital. The MOLST form must be filled out by the patient, her guardian, or health care agent, along with a medical professional, who can be a physician, nurse practitioner, or physician assistant.
View a sample MOLST form by clicking here.
The MOLST form and process are not meant to be used by healthy individuals, but by those who are ill and who want to prevent care that may do more harm than good. It also protects health care professionals and long-term care facilities from potential liability for not taking steps to provide maximum assistance to individuals in their care.
Broader use of the MOLST form should prevent unnecessary, expensive, and sometimes harmful medical treatment.
Learn more about the MOLST form and Massachusetts’s transition to the POLST form by clicking here.