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medical decision-making. One goal of the MOLST Program is to ensure that decisions to withhold or withdraw life-sustaining treatment are made in accordance with the patient's wishes, or, if the patient's wishes are not reasonably known and cannot with reasonable diligence be ascertained, in
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New York Public Health Law section 2997-c requires the "attending health care practitioner" to offer to provide patients with a terminal illness with information and counseling regarding palliative care and end-of-life options appropriate to the patient.
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Coverage for an initial preventive physical examination under
Medicare Part B includes verbal or written information regarding a patient's ability to prepare a MOLST form and the physician's willingness to issue orders on a MOLST form.
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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 (
69:). MOLST is for patients such as a terminally ill patient, whether or not treatment is provided. For this example, assume the patient retains medical decision-making
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Information about the MOLST Program can be found on the websites that
Excellus BlueCross BlueShield maintains called www.compassionandsupport.org, and www.molst.org.
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Counties. This established MOLST as a pilot program. In 2006, the law was amended to allow such "alternative forms" to be used to issue non-hospital Do Not
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services personnel. Physicians may also use the form for any patient in any setting to issue any orders for life-sustaining treatment.
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In 2008, MOLST ceased to be a pilot program when the law was amended to authorize use of the MOLST form as a non-hospital
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Patricia "Pat" Bomba, MD, spearheaded the MOLST Program since its inception. Dr. Bomba was a Vice
President at
195:. In 1991, the law was amended to authorize non-hospital orders not to resuscitate. Based upon this law, the
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for
Medical Orders for Life-Sustaining Treatment. The MOLST Program is an initiative to facilitate
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257:, the legal authority for MOLST was moved from N.Y. Public Health Law Article 29-B to a new N.Y.
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57:, that involves use of the MOLST form. Most other U.S. states have similar initiatives, such as
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authority to issue "alternative forms" for issuing non-hospital orders not to resuscitate in
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New York State
Department of Health Bureau of Emergency Medical Services Policy 11-02
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New York State
Department of Health Palliative Care Information Act web page
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created a "standard form" to issue a non-hospital order not to resuscitate (
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389:, adding a subdivision (13) to former N.Y. Public Health Law section 2977]
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Under current law, the MOLST form can be used to issue a non-hospital
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order unless the patient's heart or breathing has completely stopped.
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to make his or her own medical decisions if doing so is based upon
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In re
Westchester County Med. Ctr. ex rel. O’Connor, 72 N.Y.2d 517
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The MOLST Program is a New York State initiative that facilitates
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on behalf of an adult patient who lacks medical decision-making
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and wants to die naturally in a residential setting, not in the
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telephone call after the patient loses medical decision-making
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order in New York State, and those orders must be honored by
222:(DNI) orders. This was necessary because in New York State,
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order statewide. In 2010, along with passage of the
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law allowing surrogates to make decisions regarding
327:New York State Department of Health MOLST web page
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142:accordance with the patient's best interests.
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18:Physician Orders for Life-Sustaining Treatment
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530:United States state health legislation
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461:N.Y. Public Health Law section 2994-bb
450:N.Y. Public Health Law section 2994-dd
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313:N.Y. Public Health Law section 2994-d
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208:New York State Department of Health
197:New York State Department of Health
63:New York State Department of Health
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259:Public Health Law Article 29-CCC
255:Family Health Care Decisions Act
203:), which is still in use today.
183:Since 1987, New York has had a
133:MOLST Program in New York State
428:N.Y. laws of 2008, chapter 197
399:N.Y. laws of 2006, chapter 325
380:N.Y. laws of 2005, chapter 734
1:
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189:cardiopulmonary resuscitation
178:clear and convincing evidence
156:Legal basis in New York State
147:Excellus BlueCross BlueShield
483:OPWDD memo, January 21, 2011
446:N.Y. laws of 2010, chapter 8
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472:OMH letter, August 23, 2010
226:personnel may only honor a
33:medical decision-making in
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270:emergency medical services
224:emergency medical services
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344:Patricia A Bomba MD, FACP
180:of the patient's wishes.
97:; do not hospitalize; no
85:. Using MOLST, with the
230:order in the event of a
185:Do Not Resuscitate (DNR)
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121:who are summoned by a
488:February 4, 2011, at
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276:services personnel,
119:emergency responders
77:of a hospital on a
75:intensive-care unit
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35:New York State
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115:transfusions
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83:feeding tube
47:Rhode Island
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272:personnel,
266:DNR and DNI
251:DNR and DNI
139:end-of-life
107:antibiotics
39:Connecticut
31:end-of-life
519:Categories
296:References
170:common law
79:ventilator
16:See also:
274:home care
103:IV fluids
486:Archived
431:Archived
402:Archived
383:Archived
240:intubate
220:Intubate
216:Onondaga
201:DOH-3474
193:capacity
174:capacity
127:capacity
111:dialysis
95:intubate
71:capacity
67:DOH-5003
55:Maryland
535:Hospice
278:hospice
232:cardiac
81:with a
27:acronym
311:[See,
212:Monroe
65:form (
25:is an
123:9-1-1
113:; no
109:; no
101:; no
23:MOLST
214:and
53:and
51:Ohio
244:DNR
234:or
228:DNR
521::
319:^
304:^
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149:.
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49:,
45:,
41:,
37:,
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