Q: Do I need a MOLST?
A: The MOLST (the Maryland Medical Order for Life-Sustaining Treatment) is a way you can indicate your preferences and intentions about end-of-life care and treatment. For example, you can make it clear that you want, or do not want, CPR. You can be very detailed about your intentions, for example, that you don’t want intubation for ventilation, but that you would be OK with the CPAP or BiPAP mask, but not for longer than 2 weeks. These decisions should be thoughtful and reflective, not reflexive. A friend of mine was on “life support” for 8 years before he died, but that “life support” enabled him to fly out to California to visit his son and get to know and to baptize his grandson, to fly to Vancouver to visit friends, to spend time with his mother before she died, and many other things. His “life support” was dialysis, and while he didn’t want to be on dialysis, he was able to appreciate many of the good things of life for years before eventually succumbing to the complications of adult-onset type II diabetes that caused the kidney failure in the first place. So give your decisions some quality consideration before committing them to paper. And, to answer your question, there is no requirement at law or otherwise that you create a MOLST. Many of my clients like the idea, but some are spooked by the thought that a doctor with MOLST in hand would simply act accordingly without consulting your loved ones – it is, after all, a medical order. Some of my clients have had that happen, so you might be more comfortable filling it out and keeping it with your medical power of attorney as guidance for your medical surrogate, rather than including it in your chart. Food for thought.
Q: I have no one to make medical decisions for me – no family, no friends close enough. What do I need?
A: You don’t need a medical power of attorney if you have no one to nominate, but you still need a medical directive, to express your intentions about end-of-life decisions. You can use the MOLST. You would want this in your medical charts. There is a private site, mydirectives.com, where you can also upload your MOLST. They provide a “wallet card” for you to carry. Also, you might want to carry a copy in your car and keep a copy on your nightstand and/or the front of your fridge. You also want to give written direction about your after-death wishes – this document must be in writing and witnessed by two witnesses.
Attorney Tim Barkley
The Tim Barkley Law Offices
One Park Avenue
P.O. Box 1136
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