Downloadable Forms
Good MOLST YouTube.
MOLST (Wiki) is an acronym for Medical Orders for Life-Sustaining
Treatment. The MOLST Program is an initiative to facilitate end-of-life medical
decision-making in New York State that involves use of the MOLST form. The
MOLST form is a New York State Department of Health form. MOLST is for patients
such as a terminally ill patient who can be expected to die within six months,
whether or not treatment is provided. 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.
Some states use the term POLST (Physician's Orders For Life-Sustaining Treatment). For all practical purposes MOLST = POLST.
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