Frequently Asked Questions
What are “Medical Orders for Life-Sustaining Treatment” ?
They are written instructions from a physician, nurse practitioner or physician assistant to other health professionals (e.g. nurses, emergency responders) with orders about medical care that are based on the person's own wishes about medical treatment at the end of life.
What is “life-sustaining treatment”?
It is medical treatment that attempts to keep a person alive. Cardiopulmonary resuscitation (CPR) is one example. Health professionals are required to attempt CPR when a patient’s heart or breathing stops unless they have medical orders with other instructions.
What person might want to use the MOLST form?
MOLST is most suitable for persons of any age who have a serious advancing illness or injury that could end their life.
Who fills out the MOLST form?
A physician, nurse practitioner or physician assistnat and the person who is very sick (their health care agent, if the person lacks capacity). If no health care agent is appointed, a guardian or the parent/guardian of a minor can fill out the MOLST form to the extent permitted by Massachusetts law (seek legal counsel with questions about a guardian's authority).
When is the right time to fill out the MOLST form?
When it is clinically appropriate based on the person's current health condition, and the person wants to use the MOLST form, the MOLST form may be used after talks between the person and the physician, nurse practitioner or physician assistant about the person's health condition, prognosis, values, goals for care and possible outcomes (both positive and negative) of treatments.
Can a person be required to use the MOLST form?
No. Using MOLST is voluntary.
Can a person change his or her mind about treatment after they fill out the MOLST?
Yes. They can ask for and receive needed medical treatment at any time, no matter what the MOLST form says. A person can also revoke the MOLST form and/or ask a physician, nurse practitioner or physician assistant to fill out a new form with different instructions at any time.
Who follows MOLST instructions?
Health care professionals (nurses, emergency responders, etc.) honor valid medical orders, including MOLST.
Is MOLST the same as a "health care proxy"?
No. A health care proxy is a form that should be used by all adults ages 18 and older, whether healthy or sick, to name a "health care agent." A health care agent is the person authorized to make medical decisions for them in the future if they cannot make medical decisions (e.g. because of unconsciousness, coma, dementia or other mental limitatios). The MOLST form is used by people who are very sick and contains current and specific treatment instructions about life-sustaining treatments.
If a person has written “final wishes” or a “living will,” isn't that enough?
"Final wishes" or "living wills" are not authorized by statute in Massachusetts. They may possibly be used as evidence of a person's wishes, but they do not carry the same authority as a medical order like MOLST. Valid medical orders are to be honored by health care providers in all settings.
If a person already has a “Do Not Resuscitate” (DNR) order, can he or she still use the MOLST form?
Yes. The MOLST form includes instructions about resuscitation and other life-sustaining treatments. And, unlike a DNR order, the MOLST form can be used to refuse OR request treatments.
Who keeps the signed MOLST form?
The person keeps the MOLST with them in a place where it is easy to locate (on the refrigerator, beside the bed, or on the door), and carries it with them for trips outside the home. Copies are also valid and can be given to the health care agent and/or family members.
Will the MOLST form be honored outside of Massachusetts?
It may be honored in some states but not others. However, a MOLST form is always a good record of a person’s treatment preferences.
