Palliative Care & End of Life Care

MOLST-image

MOLST Project 

MOLST is a standardized medical order form for use by clinicians caring for patients with serious advancing illnesses.  Effective July 1, 2014, the MOLST Project will transition to the MA Department of Public Health. 

Report and Recommendation of the Massachusetts Expert Panel on End-of-Life (EOL) Care

This report describes the many gaps in EOL care.  The EOL Expert Panel has identified, and makes recommendations for both immediate and long-term steps that must be taken to address them.

 

Artificial Nutrition and Hydration:

Patients and families are often not fully informed of the relevant risks and potential benefits of artificial nutrition and hydration (ANH). In addition, financial incentives and regulatory concerns promote the use of ANH in a manner that may be inconsistent with medical evidence and with the preferences of patients and their families.

Because ANH is associated with uncertain benefits and substantial risks, it is essential to ensure that decisions about its use are consistent with the patient's medical condition, prognosis, and goals for care. Therefore, decisions about ANH require careful consideration of its risks and potential benefits.

Advance Planning:

All adults can benefit from thinking about what their healthcare choices would be if they are unable to speak for themselves. These decisions can be written down in an advance directive so that others know what they are.

Advance directives come in two main forms:

  • A "healthcare proxy" (or "healthcare power of attorney" or "agent" or "surrogate") documents the person you select to be your voice for your healthcare decisions if you cannot speak for yourself. In Massachusetts the
    healthcare proxy has full legal authority to act on behalf of the patient in all healthcare planning decisions.
  • A "living will" documents what kinds of medical treatments you would or would not want at the end of life. In Massachusetts, a living will does not have full legal authority but is a good document to have so that the healthcare provider is aware of the patient's wishes. However, all patients should have a valid healthcare proxy on file with their healthcare provider or available for their healthcare provider.

Massachusetts residents can document decisions regarding their healthcare choices and designate another individual to make healthcare decisions on their behalf through a HealthCare Proxy.  You can find two sample Massachusetts HealthCare Proxies below:

Standard HealthCare Proxy

Detailed HealthCare Proxy - this document provides a full set of legal protections that are not necessarily required in a form but is provided so the patient/provider may consider if there is relevant language to use in your own facility-specific proxy form. 

 

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