Frequently Asked Questions about MOLST

Answers for:

What is the “Medical Orders for Life-Sustaining Treatment” form?
Is the MOLST form different from other medical orders?
Why isn’t the MOLST form considered an Advance Directive?
Is MOLST the same as a "health care proxy" form?
If a person has written “final wishes” or a “living will,” isn't that enough?
Can a person be required to use the MOLST form?
If a person already has a “Do Not Resuscitate” (DNR), can they still use MOLST?
Now that MOLST is in use, is the MA Comfort Care/Do Not Resuscitate Order Verification Protocol form (CC/DNR or “Comfort Care” form) still valid?

Does the MOLST form have to be bright pink?
Does every section of the MOLST form need to be filled out for the form to be valid?
What if only Page 1 or only Page 2 of the MOLST form is received?
When does the MOLST form expire?
Who keeps the signed MOLST form?
With multiple versions of the Massachusetts MOLST form in circulation, which versions are valid? And, are future changes to the content of the MOLST form expected?
Will the MA MOLST form be honored in other states?
Regarding the patient's privacy, what suggestions do you have for keeping the MOLST available at the bed side when the patient is inpatient?

Which types of health professionals should talk to patients about MOLST decisions?
What is the process for introducing the option of using a MOLST form?
Why shouldn’t blank MOLST forms be given to or mailed to patients or their family members to preview or consider on their own?
Why does a clinician (physician, nurse practitioner, physician assistant) need to personally engage in these discussions?

Who fills out the MOLST form?
Which types of clinicians can sign a MOLST form?
Why shouldn’t blank MOLST forms be given to or mailed to patients to preview or consider on their own?
Can a facility Medical Director sign a patient’s MOLST form?
Who keeps the signed MOLST form?

What persons are most suitable for using MOLST forms?
At what stage of illness is it appropriate to consider using the MOLST form?
Should all seniors/elders have a MOLST form, or is there a certain age when the MOLST form becomes appropriate?
Can MOLST forms be used with children/pediatrics?

Who can sign the MOLST form on a patient’s behalf?
Can a spouse or next of kin or other close family friend (informal or default surrogate) sign the MOLST form, if the patient has lost capacity to make health care decisions?
Can a patient’s appointed guardian sign the MOLST form on a patient’s behalf, if the patient has lost capacity to make health care decisions?
If a patient has both an appointed health care agent and a guardian, which person can sign the MOLST form, if the patient has lost capacity to make health care decisions?
Who keeps the signed MOLST form?

Who honors MOLST instructions?
What if the clinician signer is unknown and/or doesn’t have privileges in the institution – or if a patient in crisis (with a MOLST form) has arrived and there is no clinician around?
If a patient has a MOLST on file in their record from a past visit and arrives with no MOLST form in hand, should the form on-hand in the file be honored?
What if the MOLST form says “Attempt Resuscitation” but also says “Do Not Intubate and Ventilate” and/or “Do Not Transfer to Hospital (unless needed for comfort)?
Can a hospice patient select “Do Not Transfer to Hospital (unless needed for comfort)?
Regarding the patient's privacy, what suggestions do you have for keeping the MOLST available at the bed side when the patient is inpatient?
With multiple versions of the Massachusetts MOLST form in circulation, which versions are valid? And, are future changes to the content of the MOLST form expected?
Will the MA MOLST form be honored in other states?

What if there is a MOLST and a CC-DNR that say different things?
What if there are multiple MOLST forms for the patient, and they say different things?
What if a patient’s family member or significant other disagrees with the instructions on the MOLST form?
Now that the MOLST form is in use, is the Massachusetts Comfort Care/Do Not Resuscitate Order Verification Protocol form (CC/DNR form or “Comfort Care” form) still valid?

Can a person change his or her mind about treatment after they fill out the MOLST?
Does the patient have to go back to the original clinician to re-discuss the MOLST?
What if a patient wants to change one page of the MOLST form, but not the other?
What if a patient’s family member or significant other disagrees with the MOLST instructions?
How do you change MOLST forms in the Electronic Health Record (EHR)?