MCA Continuing Work on MOLST Legislation
Midwest Care Alliance continues to meet with other provider groups, interested parties, and legislators and to draft and introduce a bill that will replace Ohio’s current DNR law with Medical Orders for Life Sustaining Treatment (MOLST). The creation of a uniform MOLST form is based on effective communication of patient wishes, documentation of medical orders, and a promise by health care professionals to honor these wishes.
Key Elements for Proposed MOLST Legislation
The purpose of MOLST legislation in Ohio is to replace current Ohio DNR law with a uniform MOLST form, which will encourage and facilitate more communication about end of life decisions, while allowing patients and medical professionals more flexibility to make these considerations as patients’ medical conditions change. The bill should:
- Be patient-centered and patient-driven. The uniform MOLST form will allow the patient, or decision-maker, to better understand and drive his or her own end of life care, including those decisions regarding the administration of life-sustaining treatment even if those instructions are inconsistent with instructions in a previously executed advance directive. The MOLST form will also allow patients to determine a medical decision-maker should the patient become unable to make those decisions.
- Eliminate current Ohio DNR law, and replace it with MOLST and the MOLST form. The MOLST legislation and new language is intended to replace current DNR law in Ohio, to make end of life decision making more patient-centered and patient-driven.
- Make clear that no one is required to complete a MOLST form. The MOLST form is a way to uniformly document and transfer end of life medical orders. Just like any medical order, a patient or decision-maker should discuss and understand the options carefully with his or her medical professional. No one is required to complete a MOLST form, and this statement will be included on the form itself. Further, nothing in the legislation, or on the MOLST form, will create a bias in favor of more aggressive or less aggressive forms of treatment.
- Assure that the MOLST form is transferrable across settings of care. A MOLST form will be transferable across all settings, including emergency settings. A copy of a MOLST form is equally valid as an original, and medical professionals will be required to notify other medical professionals if they know a patient or decision-maker has completed a MOLST form.
- Provide immunity to all health care workers who honor the medical orders outlined in a MOLST form, if acting under their scope of practice. Like current DNR law, new MOLST law will protect health care personnel from civil and criminal liability who follow end of life medical orders outlined in a patient’s MOLST form.
Midwest Care Alliance will keep you informed as we move forward with MOLST legislation. For more information on the MOLST/POLST paradigm, visit http://www.ohsu.edu/polst. For more information on Midwest Care Alliance’s involvement with Ohio legislation, contact Jeff Lycan or Katie Rogers.