More about MOLST: Medical Orders for Life-Sustaining Treatment

What is a MOLST form?

  • MOLST stands for Medical Orders for Life-Sustaining Treatment
  • It is a document that consolidates existing orders related to Cardiopulmonary Resuscitation (CPR), Do Not Resuscitate (DNR) orders, and a patient’s wishes about what treatments they would like or not like to receive in all Maryland care settings
  • Unlike a Living will or Advanced Healthcare Directive which contain preferences about hypothetical situations, a MOLST form documents a patient’s wishes relevant to their then current health condition
  • While there is no required number of treatment options that must be selected the form aims to provide as many options as possible in a clear and concise manner

How a MOLST form works:

  • Patients and authorized representatives cannot complete the form themselves, but should use the Health Care Decision Making Worksheet to make treatment decisions
  • A physician or nurse practitioner then completes a MOLST order sheet reflecting their patient’s wishes
  • MOLSTs become valid as soon as they are signed by a Maryland licensed physician or nurse practitioner who then becomes responsible for insuring the basis and accuracy for the orders contained within
  • The patient/authorized representative must receive a copy within 48 hours of completion
  • Orders about treatment to be administered or withheld are to be honored as specified; the exception being if two physicians certify a treatment would be medically ineffective. In these cases the treatment can be withheld

Other things to keep in mind:

  • Orders can be updated, revised, or rescinded at any time as long as the patient is competent to make decisions or their health care agent such as an Attorney in Fact (established in a Power of Attorney document) is present
  • A MOLST form is a reflection of current medical situations and should be updated at least yearly; new forms should be completed and signed whenever changes are made
  • Be sure MOLST forms are kept in visible places, they are a part of your medical records and that they are transferred when any change of care setting is made
  • Copies or faxed versions of the form are just as valid as originals
  • While a MOLST form must be signed by a Maryland licensed physician or nurse practitioner to be valid, a Physician’s Orders for Life-Sustaining Treatment form or DNR order valid in another state may be honored and should be presented

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