Health Professionals FAQ
What is a “Medical Orders for Life-Sustaining Treatment” (MOLST) Form?
The MOLST form is a two-page standardized form containing valid medical orders for life-sustaining treatment based on a patient’s own preferences and goals of care.
How is MOLST authorized in Massachusetts?
The MOLST process and form is authorized by the Massachusetts Department of Health and Human Services. EMTs are required to honor valid MOLST forms per Office of Emergency Medical Services protocol.
Which patients should consider having a MOLST form?
Patients of any age with a serious advancing medical condition including, but not limited to, life threatening disease or injury, chronic progressive disease, dementia or medical frailty; and any patient suitable for a DNR order.
Can a patient be required to have a MOLST form?
No. Using MOLST is voluntary and a patient or the patient’s authorized representative* can revoke MOLST at any time.
Who should discuss MOLST with patients?
All physicians, nurse practitioners or physician assistants in any setting should talk about advance care planning with patients and document treatment preferences as appropriate—regardless of specialty or length of relationship with the patient. Such conversations may include discussing MOLST.
Who can fill out and sign a patient’s MOLST form?
A physician, nurse practitioner or physician assistant and the patient or patient’s authorized representative.
What makes a MOLST form valid?
For Page 1 to be valid, every part of Sections D and E must be filled in completely and legibly. For Page 2 to be valid, every part of Sections G and H must be filled in completely and legibly. Each page can be valid independent of the other.
Where is the signed MOLST form kept?
With the patient. Send the original with the patient at discharge or during transfer between care settings. Instruct patients to place the form where it will be easy to locate at home (door, bedside, or refrigerator) and to carry it in a purse or wallet outside the home. Put a copy (not the original) of the MOLST form in the patient’s medical record.
Are copies of valid MOLST forms valid?
Yes. An electronic, fax or photocopy of a valid MOLST form on any color of paper is valid.
Do I honor a patient’s MOLST form, even if I do not know the patient or the signing clinician?
Yes. Honor the MOLST form the same way you would follow any other medical order, until a physician, nurse practitioner or physician assistant can assess the clinical situation.
What if a patient has both a CC/DNR (“Comfort Care”) form and a MOLST form?
For cardiac or respiratory arrest, follow the most recent orders. In other situations, follow the MOLST orders.
