US Legal Forms
Maryland Medical Order for Life-Sustaining Treatment / MOLST

Maryland Medical Order for Life-Sustaining Treatment / MOLST

Category:

Power of Attorney - Healthcare - Living Wills

State:

Maryland

Control #:

MD-P023C

Format:

Instant download

Definition and meaning

The Maryland Medical Order for Life-Sustaining Treatment (MOLST) is a legal document that outlines a patient's medical preferences regarding life-sustaining treatments. This order is specifically designed for use by emergency medical services (EMS) and healthcare providers. It helps to ensure that a patient's wishes are respected in critical situations, especially when they cannot communicate their desires.

Who should use this form

The MOLST form should be utilized by individuals who have specific medical needs or who wish to communicate their healthcare preferences regarding end-of-life treatment. This includes individuals with terminal illnesses, chronic health conditions, or those who wish to clarify their treatment preferences in emergencies. It is essential for patients, their healthcare agents, guardians, or surrogates to be involved in the discussion and completion of this form.

Key components of the form

The MOLST form contains several crucial sections that guide the patient's healthcare decisions:

CPR Status: Indicates whether to attempt cardiopulmonary resuscitation (CPR) in case of arrest.
Artificial Ventilation: Outlines the patient's wishes regarding intubation and ventilation options.
Blood Transfusion: Specifies whether blood products can be administered.
Transfer to Hospital: States the conditions under which hospital transfer is desired.
Antibiotics: Clarifies preferences for antibiotic use.
Dialysis: Indicates whether dialysis is accepted if medically indicated.

How to complete a form

To properly complete the MOLST form, the following steps should be taken:

Discuss treatment options with a healthcare professional, such as a physician or nurse practitioner.
Complete each section by selecting only one option that applies to the patient’s wishes.
Ensure that the form is signed and dated by the healthcare provider.
Provide copies of the completed form to the patient or their authorized decision maker within 48 hours.
Keep a copy in the patient’s medical records for easy access during emergencies.

Benefits of using this form online

Using the MOLST form online has several advantages:

Accessibility: The online format allows users to access, fill out, and print the form from anywhere at any time.
Convenience: Streamlines the process of discussing and documenting health care preferences without the need for face-to-face meetings.
Updated Information: Ensures that users have access to the most current form and guidelines as set by Maryland regulations.

Common mistakes to avoid when using this form

While completing the MOLST form, be mindful of these common pitfalls:

Failing to discuss the form with a healthcare provider, leading to uninformed decisions.
Not signing or dating the form, rendering it invalid.
Leaving sections blank when they should be filled, which could create confusion about the patient’s wishes.
Providing copies to the wrong individuals, which may compromise the patient’s preferences being respected.

JURY-1990-20 Jurors (Parking Cost Reimbursement for Buffalo Jurors), June 14, 1990.pdf

View this form

FOR-2011-98 Forfeiture Collateral in Lieu of Appearance, 6-24-11.pdf

View this form

FIN-1994-38 Deposits of Money into the Registry of the Court, Sept 20, 1994.pdf

View this form

SEC-2010-89 Courthouse Security & Limitations on the Possession & Use of Personal Elecronic Devices, 5-14-10.pdf

View this form

ECF-2007-73 Abrogating Orders 68 and 69, December 7, 2007.pdf

View this form

Original Notice - Nonresident Motor Vehicl...

View this form

Provision Addressing Air Conditioning Vent...

View this form

Record of Unanimous Consent of Directors i...

View this form

Sample Letter for Happy Father's Day - To ...

View this form

Quitclaim Deed from Corporation to Individual

View this form

Request for Proof of Debt

View this form

Affidavit or Proof of No Income - Unemploy...

View this form

Deed of Gift

View this form

Collective Bargaining Agreement Between Un...

View this form

Disclosure Statement Required for Resident...

View this form

Power of Attorney and Living Will / Health Care Directive

Take advantage of personalized templates with US Legal Forms. Complete a simple survey to describe your case and get the appropriate Power of Attorney for your state and situation.

Try now

Form popularity

FAQ

The primary difference between and POLST and DNR is that a POLST covers a variety of end-of-life treatments. A DNR only gives instructions about CPR. With a POLST, seniors can specify: If they do or don't want CPR.

Medical Orders for Life- Sustaining Treatment (MOLST in OH), Physician Orders for Scope of Treatment (POST in IN), or Pennsylvania Orders for Life-Sustaining Treatment (POLST in PA) is a program designed to improve the quality of care patients receive at the end of life by stating patient goals for care and preferences

MOLST is a form that contains directions about CPR and other life-sustaining treatments specific to your current condition. To be valid, a MOLST form must be signed and dated by a licensed Maryland medical provider a physician, nurse practitioner or physician's assistant.

A physician/nurse practitioner/physician assistant must sign the MOLST form. All health care professionals must follow these medical orders as the patient moves from one location to another, unless a physician/nurse practitioner/physician assistant examines the patient, reviews the orders, and changes them.

There are five main aspects of personal health: physical, emotional, social, spiritual, and intellectual.

Being healthy should be part of your overall lifestyle. Living a healthy lifestyle can help prevent chronic diseases and long-term illnesses. Feeling good about yourself and taking care of your health are important for your self-esteem and self-image. Maintain a healthy lifestyle by doing what is right for your body.

Normal body temperature (98.6 degrees Fahrenheit and 37 degrees Celsius) is a sign of being healthy, explains Dr Becker. When body temperature varies from its normal range, it can be a sign of illness, either acute or chronic and it can indicate certain types of health problems.

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Trusted and secure by over 3 million people of the world’s leading companies

Maryland Medical Order for Life-Sustaining Treatment / MOLST

Living Wills - General - Maryland

Related Maryland Legal Forms

STATUTORY REFERENCE ALL REFERENCES ARE TO THE MARYLAND CODE ADVANCE HEALTH CARE DIRECTIVE (§§ 5-601 through 5-608 -Health-General) Selected Definitions An "advance directive" is:

A witnessed written document, voluntarily executed by the declarant in accordance with the statutory requirements; or A witnessed oral statement, made by the declarant in accordance with the statutory requirements.

An "agent" is an adult appointed by the declarant under an advance directive made in accordance with the provisions of this subtitle to make health care decisions for the declarant. A "competent individual is a person who is at least 18 years of age or who under § 20-102 (a) of this article has the same capacity as an adult to consent to medical treatment and who has not been determined to be incapable of making an informed decision. The "declarant" is a competent individual who makes an advance directive while capable of making and communicating an informed decision. A "life sustaining procedure" (which includes includes artificially administered hydration and nutrition, and cardiopulmonary resuscitation) is any medical procedure, treatment, or intervention that:

Utilizes mechanical or other artificial means to sustain, restore, or supplant a spontaneous vital function; and Is of such a nature as to afford a patient no reasonable expectation of recovery from a terminal condition, persistent vegetative state, or end-stage condition.

A "persistent vegetative state" is a condition caused by injury, disease, or illness:

In which a patient has suffered a loss of consciousness, exhibiting no behavioral evidence of self-awareness or awareness of surroundings in a learned manner other than reflex activity of muscles and nerves for low level conditioned response; and From which, after the passage of a medically appropriate period of time, it can be determined, to a reasonable degree of medical certainty, that there can be no recovery.

A 'terminal condition" is an incurable condition caused by injury, disease, or illness which, to a reasonable degree of medical certainty, makes death imminent and from which, despite the application of life sustaining procedures, there can be no recovery. Procedure - Living Will Any competent individual may, at any time, make a written advance directive regarding the provision of health care to that individual, or the withholding or withdrawal of health care from that individual. Agent Any competent individual may, at any time, make a written advance directive appointing an agent to make health care decisions for the individual under the circumstances stated in the advance directive. An owner, operator, or employee of a health care facility from which the declarant is receiving health care may not serve as a health care agent unless the person would qualify as a surrogate decision maker under § 5-605 (a). An agent has decision making priority over any individuals otherwise authorized under this subtitle to make health care decisions for a declarant. Signature and Witnesses A written advance directive must be dated, signed by or at the express direction of the declarant, and subscribed by two witnesses. Any competent individual may serve as a witness to an advance directive, including an employee of a health care facility or physician caring for the declarant if acting in good faith. The health care agent of the declarant may not serve as a witness. At least one of the witnesses must be an individual who is not knowingly entitled to any portion of the estate of the declarant or knowingly entitled to any financial benefit by reason of the death of the declarant. Oral Directive Any competent individual may make an oral advance directive to authorize the providing, withholding, or withdrawing of any life sustaining procedure or to appoint an agent to make health care decisions for the individual. An oral advance directive shall have the same effect as a written advance directive if made in the presence of the attending physician and one witness and documented as part of the individual's medical record. The documentation shall be dated and signed by the attending physician and the witness. Effectiveness of Advance Directive Unless otherwise provided in the document, an advance directive shall become effective when the declarant's attending physician and a second physician certify in writing that the patient is incapable of making an informed decision. If a patient is unconscious, or unable to communicate by any means, the certification of a second physician is not required. Notice A declarant has the responsibility to notify the attending physician that an advance directive has been made. In the event the declarant becomes comatose, incompetent, or otherwise incapable of communication, any other person may notify the physician of the existence of an advance directive. An attending physician who is notified of the existence of the advance directive must:

If the advance directive is written, make the advance directive or a copy of the advance directive a part of the declarant's medical records; or If the advance directive is oral, make the fact of the advance directive, including the date the advance directive was made and the name of the attending physician, a part of the declarant's medical records.

A declarant has the responsibility to notify the a health care agent that the agent has been named in an advance directive to act on the declarant's behalf. Form Use of the statutory form is optional. Revocation An advance directive may be revoked at any time by a declarant by a signed and dated writing, by physical cancellation or destruction, by an oral statement to a health care practitioner or by the execution of a subsequent directive. It is the responsibility of the declarant, to the extent reasonably possible, to notify any person to whom the declarant has provided a copy of the directive. Anatomical Gifts in Advance Directive An advance directive may contain a statement by a declarant that the declarant consents to the gift of all or any part of the declarant's body for any one or more of the purposes specified in Title 4, Subtitle 5 of the Estates and Trusts Article. Note: All Information and Previews are subject to the Disclaimer located on the main forms page, and also linked at the bottom of all search results.

Related Maryland Legal Forms

Maryland Medical Order for Life-Sustaining Treatment / MOLST

Living Wills - General - Maryland

Related Maryland Legal Forms

A witnessed written document, voluntarily executed by the declarant in accordance with the statutory requirements; or A witnessed oral statement, made by the declarant in accordance with the statutory requirements.

Utilizes mechanical or other artificial means to sustain, restore, or supplant a spontaneous vital function; and Is of such a nature as to afford a patient no reasonable expectation of recovery from a terminal condition, persistent vegetative state, or end-stage condition.

A "persistent vegetative state" is a condition caused by injury, disease, or illness:

In which a patient has suffered a loss of consciousness, exhibiting no behavioral evidence of self-awareness or awareness of surroundings in a learned manner other than reflex activity of muscles and nerves for low level conditioned response; and From which, after the passage of a medically appropriate period of time, it can be determined, to a reasonable degree of medical certainty, that there can be no recovery.

If the advance directive is written, make the advance directive or a copy of the advance directive a part of the declarant's medical records; or If the advance directive is oral, make the fact of the advance directive, including the date the advance directive was made and the name of the attending physician, a part of the declarant's medical records.

Maryland Medical Order for Life-Sustaining Treatment / MOLST

Definition and meaning

Who should use this form

Key components of the form

How to complete a form

Benefits of using this form online

Common mistakes to avoid when using this form

Related forms

Viewed forms

Power of Attorney and Living Will / Health Care Directive

Form popularity

FAQ

How do you complete a Molst form?

What is the difference between Molst and Polst?

How do I fill out a Molst form?

What is a Molst form in Maryland?

Who can sign a Molst form in NYS?

What are the 5 types of health?

What is the importance of health?

What is the sign of good health?

How do you define health?

Trusted and secure by over 3 million people of the world’s leading companies