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Health Care Wishes: How Do You Make Sense of All the Forms?

Since its expansion in 2012, the Massachusetts Medical Orders for Life-Sustaining Treatment (MOLST) is becoming the standard practice for memorializing a patient’s preferences for end-of-life care.  And it is causing some confusion.  Here are the essential facts about documents that you can use to express healthcare preferences when you are no longer able to make your own decisions.

Health Care Proxy:  You should have this document appointing an agent to make health care choices for you if you lack the capacity to make or to communicate health care decisions.  It is legally enforceable in Massachusetts and in other states.

Living Will:  You may express in writing how you wish to be cared for when you become terminally ill.  Although this document is not legally binding in Massachusetts, it is helpful as a guide to your doctors and family.  Similar provisions may be included in your Health Care Proxy.

Do Not Resuscitate Order (DNR):  This alerts medical workers not to use cardiopulmonary resuscitation (CPR) to try to save your life if your heart stops or you stop breathing.  If you do not want CPR to be used, you must obtain a DNR order from your doctor.  It is valid only in a hospital or nursing home setting unless you have executed a Comfort Care DNR Order Verification.

Comfort Care/DNR Order Verification:  This form verifies that your DNR should be honored in out-of-hospital settings.  It is completed by you and your doctor, nurse practitioner, or physician assistant.  Both this form and the MOLST form are in use, but the MOLST form is becoming more common.