MOST and DNR Forms – the other side of Advance Directives

Health Care

Lawyers routinely prepare advance directives for their clients – in North Carolina the statutory form was previously called a “Declaration of a Desire for a Natural Death, “and is now just known as an “Advance Directive (Living Will).”  Also used, to a lesser extent, is the “Advance Instruction for Mental Health Treatment.”

I am often asked about the Do Not Resuscitate (DNR) form, and sometimes people confuse it with the Living Will advance directive.  There is also a newer form called the Medical Order for Scope of Treatment (MOST).  There are significant differences in these two forms and the Living Will.  First of all, the yellow DNR and pink MOST forms are only available to and must be signed by physicians.  The DNR and MOST are sometimes referred to as “portable” medical orders because patients can keep copies at home or on their person.  The DNR contains an order to not resuscitate in the event of pulmonary or cardiac arrest, while the MOST form is much broader.  It has sections dealing with cardiopulmonary arrest, medical interventions, antibiotics, and artificial hydration and nutrition, and describes the treatment(s) the patient may want or not want.  The DNR and MOST are generally used only by elderly or seriously ill persons.
As I tell my clients, the DNR and MOST forms deal with acute situations, while the Living Will deals with chronic situations.  Not everyone should have a DNR or even a MOST, but to round out a complete health care plan everyone should have a Health Care Power of Attorney, Living Will and HIPAA form (Authorization for Use and Disclosure of Protected Health Care Information).
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