On January 20, 2010, the Center and SUNY Downstate Medical Center sponsored a roundtable discussion at the Law School on Medical Orders for Life Sustaining Treatment (MOLST). The primary purpose of the meeting was to gather information about this legal document on clinical care and its impact on public understanding of others, such as the healthcare proxy. Participants included an interdisciplinary mix of health lawyers, physicians, policy analysts, palliative care professionals, students, and academics.
MOLST is a form that represents the legal equivalent of an inpatient do not resuscitate (DNR) form. The form is used to communicate physician orders regarding cardiopulmonary resuscitation and life-sustaining treatment at the end of life. Dr. Patricia A. Bomba, Vice President and Medical Director of Geriatrics at Excellus Blue Cross Blue Shield, gave a presentation that described the launch of the MOLST initiative, emphasizing the value of this legal document to patients and families that face difficult decisions at the end of life. Useful information was gathered about perceptions of the value of the form and geographic differences in its acceptance and usage.
Not long after this meeting, Governor Paterson signed the Family Healthcare Decisions Act (FHCDA) into law. The law creates a legal mechanism for the appointment of a healthcare surrogate to make healthcare decisions for individuals who become incapacitated and have not prepared advance directives regarding their wishes. It empowers family members and others close to patients to make medical decisions for them in the event that they cannot do so themselves. In light of the new law, a follow-up meeting was held in early May to discuss proposed changes to the MOLST form and questions raised by the FHCDA.