Q: What is the difference between a MOLST Form and a DNR?
A: While these forms should be a topic of discussion when considering your advance directives, it is crucial to understand that MOLST forms and DNRs are not legal documents in themselves, but rather medical orders that guide healthcare providers in critical situations. Knowing the distinction between the two can help you make informed decisions about your healthcare and ensure that your wishes are followed during serious medical events.
MOLST stands for “Medical Order for Life-Sustaining Treatment.” MOLST forms are medical documents created by the New York State Department of Health for patients with serious health conditions who may want to avoid or receive any or all life-sustaining treatments. Patients who typically consider MOLST forms may reside in long-term care facilities, require ongoing medical or personal care, or may face the possibility of passing away within the next year. MOLST forms are unique because they are the only authorized forms in New York for documenting both nonhospital Do Not Resuscitate (DNR) and nonhospital Do Not Intubate (DNI) orders. These forms provide clear, specific medical instructions and are recognized in a variety of healthcare settings, including hospitals, nursing homes, and during emergency medical services. MOLST is signed by a New York State-licensed physician, nurse practitioner, or physician assistant, which gives it the authority to guide medical professionals in urgent situations.
A DNR, or Do Not Resuscitate order, is also a medical document but has a narrower focus compared to a MOLST form. Specifically, a DNR instructs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if a patient’s heart stops or they stop breathing. Individuals with decision-making capacity can consent to a DNR verbally or in writing, whereas if a person lacks capacity, their healthcare agent can provide consent on their behalf. DNRs are generally simpler documents but are important for communicating specific wishes regarding resuscitation efforts.
In addition to MOLST and DNR orders, there are healthcare-related estate planning documents that individuals can implement well before facing serious health issues. One such document is a Health Care Proxy, which can be executed by anyone regardless of current health status. By designating an agent through a Health Care Proxy, an individual empowers someone they trust—who must be at least 18 years old—to make medical decisions on their behalf if they lose the capacity to do so themselves. It is essential to choose an agent who understands your values, preferences, and priorities, as this person will be responsible for ensuring your healthcare wishes are honored under various circumstances.
A living will is another critical tool in healthcare planning and can be executed at any time. Living wills typically provide authorization for your designated healthcare agent to withhold or withdraw life-sustaining treatment if necessary. These documents allow you to outline your preferences for care, including steps to minimize pain, even if the administration of certain medications may hasten death. Living wills can specify treatments your agent can direct to be withheld or withdrawn, such as dialysis, antibiotics, or feeding tubes. The purpose of these documents is to ensure that you retain control over your healthcare choices and provide guidance to your loved ones and medical professionals when you cannot speak for yourself.
It is important for individuals to educate themselves on all available options for healthcare planning, including MOLST, DNR orders, Health Care Proxies, and living wills. Taking proactive steps to create these documents can alleviate stress and uncertainty for both patients and their families during medical emergencies. By clearly articulating your preferences in advance, you can reduce the likelihood of conflict among family members and ensure that your healthcare aligns with your values and goals.
Britt Burner, Esq. is the Managing Partner at Burner Prudenti Law, P.C. focusing her practice areas on Estate Planning and Elder Law. Erin Cullen, Esq. is an associate attorney at Burner Prudenti Law, P.C. focusing her practice on Trusts and Estates. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton. Their team provides guidance on legal and healthcare planning documents, helping clients make informed decisions that protect their future and safeguard their wishes in all medical circumstances.