What is MOLST?
By: Brandon C. Walecka, Esq.
Walecka Law, P.C.
MOLST is a medical order containing the patient’s preferences about life-sustaining medical treatments. A MOLST form is signed by the patient (or health care agent/guardian) and the clinician. The MOLST is the doctor’s order.
Where does MOLST fit in advanced care planning?
There are several documents that are commonly used in estate planning that relate to a person’s medical care. MOLST is designed to work with these documents. Here is a brief description of the common documents: Healthcare Proxy, personal directive/living will, HIPAA release, and how MOLST works with these documents.
Everyone age 18 and older should have a Health Care Proxy to appoint a Health Care Agent. It is a legal document in which you designate who you want to make your medical decisions for you if you cannot make them for yourself.
A personal directive, also called a living will or an advanced directive, is a document in which you tell your family, doctors, and friends what types of decisions you would like made for you if you cannot speak for yourself. It is the place for you to indicate if you would like extreme measures taken to preserve your life (life support) or if you would not like your life extended through extreme measures. It also has a place for you to indicate how you would like to be buried and any special things you would like related to your memorial services. This document is not legally binding on a doctor or your health care proxy, but it is good guidance for your family.
A HIPAA Release is a document in which you authorize the people listed on it to access your medical information. It is needed because the Health Insurance Portability and Accountability Act (HIPAA) prohibits access to your medical information for anyone except yourself. This makes it very difficult for family members to assist each other with medical issues such as insurance inquiries, learning test results, speaking to a doctor or pharmacy about a prescription, etc. The HIPAA Release names an agent who can fax or give a copy of the HIPAA Release to the medical provider or insurance company, who then will be allowed to speak with that person/agent.
A MOLST Form is appropriate if an individual is diagnosed with an advanced illness (at any age), chronic progressive disease, and life-threatening injuries or with medical frailty produced by advanced age. If you have a serious illness, your physician can fill out a MOLST form addressing the steps you’d like followed (or not followed) in various scenarios. This MOLST form then becomes part of your medical record. You need to keep a copy with you wherever you go. This way, the EMS personnel will know your wishes regarding life sustaining treatment and should honor them. Unlike the personal directive, this is a legal document.
Benefits of MOLST
The MOLST Form hopes to provide clear, standardized instructions for health care personnel. Also, unlike a living will, which is merely guidance to a decision maker, the MOLST is a medical order signed by a doctor. This means that medical personnel should follow the directions in the MOLST. The MOLST form is designed to address the gap between the personal directive and real-time decisions made by medical personnel. Another benefit is that the MOLST order is portable; it should follow you in your medical chart (from hospital to rehab to nursing home).
Interested in learning more about MOLST? Speak with your doctor and check out the MOLST website at www.molst-ma.org for more details including trainings, FAQs, and stories.
The information contained in this article is not intended to make you an expert on estate planning nor is this article intended to replace the need for the advice of a professional. Rather, this article is simply intended to provide a basic understanding of why estate planning is important for everybody and a basic understanding of some of the more common estate planning tools. This article does not constitute legal advice.