Medical Orders for Life-Sustaining Treatment

[1] For this example, assume the patient retains medical decision-making capacity and wants to die naturally in a residential setting, not in the intensive-care unit of a hospital on a ventilator with a feeding tube.

Using MOLST, with the informed consent of the patient, the patient's doctor could issue medical orders for life-sustaining treatment, including any or all of the following medical orders: provide comfort measures (palliative care) only; do not attempt resuscitation (allow natural death); do not intubate; do not hospitalize; no feeding tube; no IV fluids; do not use antibiotics; no dialysis; no transfusions.

The orders should be honored by all health care providers in any setting, including emergency responders who are summoned by a 9-1-1 telephone call after the patient loses medical decision-making capacity.

[4] Information about the MOLST Program can be found on the websites that Excellus BlueCross BlueShield maintains called www.compassionandsupport.org, and www.molst.org.

[7] Based upon this law, the New York State Department of Health created a "standard form" to issue a non-hospital order not to resuscitate (DOH-3474), which is still in use today.