Medical Orders for Life-Sustaining Treatment

Origin of MOLST


The Massachusetts MOLST program was designed based on the "physician orders for life-sustaining treatment (POLST) paradigm program."

What is the POLST paradigm?

The goal of the POLST paradigm is to ensure that seriously ill patients' preferences about life-sustaining treatments are known, communicated and honored across all health care settings. A POLST paradigm program is based on:

  • Effective communication of patient wishes
  • Documentation of medical orders on a brightly colored form
  • A commitment by health care professionals to honor these wishes

Is the POLST paradigm used in other places?

The POLST paradigm began in Oregon in 1991 to improve clinical adherence to patients’ end-of-life treatment wishes.  

As the Oregon program evolved, POLST paradigm programs were developed in other communities and states.

In 2004, the leaders of the earliest POLST programs formed a National POLST Paradigm Initiative Task Force with the aim of supporting the development of POLST paradigm programs throughout the United States.