Maryland Medical Orders for Life-Sustaining Treatment (MOLST)

A Maryland MOLST expresses the care you wish to receive or have withheld in a life-limiting situation.

Maryland MOLST is a portable and enduring form for orders about life-sustaining treatments, including cardiopulmonary resuscitation.

This form makes your treatment wishes known to health care professionals. It includes many sections, but the only sections that are completed are the ones that identify the decisions that you have made about your treatment preferences.

Every time a physician or nurse practitioner completes a MOLST with your wishes, you will get a copy for your records. This form does not expire and it goes with you where you go—to the hospital, rehad, assisted living, and back home.

In Maryland, a Medical Orders for Life-Sustaining Treatment (MOLST) form is a document that replaces the Maryland Do Not Resuscitate (DNR) form.

Is a MOLST different than an Advance Health Care Directive?

An AHCD contains instructions about future hypothetical healthcare situations. A MOLST Order documents a patient’s wishes relevant to then current healthcare conditions and needs.

The goal of a MOLST form is to provide as many clear and concise healthcare options as possible. Patients are presented health care situations and potential treatments. They are asked to check which treatments they would like to receive or have withheld in those specific situations.


How do I make my wishes about the care I would like to receive known?

In Maryland, a patient or their legal representatives complete a Health Care Decision Making Worksheet. These forms contain numerous medical situations and potential treatment options. The desired treatments are selected to be administered or withheld and this information is put into a MOLST Order Form by a doctor or nurse practitioner who then signs it.

After execution these are the instructions to be followed in the given situations until an updated form is completed and signed.

What happens if there are contradictory instructions?

If more than one completed MOLST Order exists:

  • The most recent valid order its instructions are to be followed.

If family members, friends, etc. want to pursue different treatment(s):

  • Without documents naming them as Guardian of your Person or Healthcare Agent
    no-one can change these decisions.

If decisions seem to go against medical advice:

  • A MOLST Order may be modified against the grantor’s wishes is if two (2) physicians certify the patient’s desired treatment would be medically ineffective.

What if I change my mind?

A MOLST Order can be changed, updated, or rescinded at any time as long as the grantor is mentally competent. They complete a new Health Care Decision Making Worksheet which is turned into a new MOLST Order.

Things to consider:

  • If there are no given limitations on care, CPR and other life sustaining treatments may be given until a MOLST Order Form can be completed
  • Copies of faxed versions of a MOLST Order are as valid as an original
  • Existing forms such as an old Do Not Resuscitate Order are still valid and will be honored
  • Patients should receive copies of the MOLST Order within 24 hours of its signing
  • The medical professional that signs a MOLST Order is responsible for ensuring the instructions are followed
  • A new Health Care Decision Making Worksheet should be completed as frequently as needed when circumstances and health conditions change
  • Completed but not signed forms are not valid

Disclaimer – This overview is provided for general information relevant for planning undertaken in Maryland only. None of the information within should be relied upon. Statutes, regulations, and the cases interpreting them are constantly changing. Consult an attorney before taking any action. Your reliance on or use of this information does not create an attorney/client relationship or privilege between you and the law firm and its employees, or their heirs, personal representatives, successors, or assigns.


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