MOST Form. Living Will. Health Care Power of Attorney. Advance Directive.
We hear about them. We know someday we might need them. But how do they work? Do I need one of them? Some of them? All of them?
The Living Will
A Living Will is a specific type of document specifying the life-sustaining intervention you would desire to extend your life if you are terminally ill or in a persistent vegetative state.
Effectively, a Living Will offers more general guidance to your loved ones about your wishes at the end of life.
It is a gift that you can give your loved ones so that they are not left wondering what you would have wanted, at a time when you are no longer able to communicate your preferences.
The Advance Directive
The Advance Directive is a broader document comprising two parts.
One part of the Advance Directive, the Living Will, is usually only one part.
The second part of an Advance Directive is often called a “Health Care Power of Attorney” or “Medical Power of Attorney”. Amongst the purposes of this document, we usually:
- Appoint a decision-maker, usually called a “Health Care Surrogate”, who is legally recognized to speak to doctors and give instructions on your behalf regarding your care and treatment if you are unable to render informed consent.
- Provide a HIPAA release to your Health Care Surrogate so that your Health Care Surrogate can make informed decisions.
- Release health care providers from liability for relying in good faith on the instructions and directions of your Health Care Surrogate.
Put simply, executing a Living Will alone does not go far enough. It is important to complete both parts of the Advance Directive so that you can make your preferences known and appoint a trusted individual to carry them out.
The MOST (or MOLST) Form
A District of Columbia MOST Form (Medical Orders for Scope of Treatment) or a Maryland MOLST Form (Maryland Order for Life Sustaining Treatment) is a more detailed form of a Living Will.
Unlike a Living Will, which speaks in more broad terms about life-sustaining treatment, the MOST Form is what is commonly referred to as a “DNR”. It speaks to specific medical procedures such as CPR, intubation, and blood transfusions, and to when those procedures may be used (and when they are to be withheld).
This document is a binding medical order that can be completed by a patient (or a patient’s Health Care Surrogate) with a treating physician or nurse practitioner. An attorney cannot complete this form with a client; all the attorney can do is provide the form to a client to complete with a medical professional.
Clients can (and often do) have both a MOST Form and a Living Will. It is important, of course, for clients to make sure the documents are not in conflict with each other.
Concluding Thoughts
At a minimum, each individual over the age of 18 should have an Advance Directive that includes both a Living Will and a Health Care Power of Attorney. Clients who have strong feelings about end-of-life care may choose to complete a MOST Form. In any event, it is important for any documents, once executed, to be provided to a primary care physician for inclusion in the client’s medical records.
What other questions do you have about the core planning documents you need? Reach out to the estate attorneys at Bulman Dunie. Contact Jeremy Rachlin at (301) 656-1177 x305 or jrachlin@bulmandunie.com or Liz Farley at (301) 656-1177 x316 or lfarley@bulmandunie.com.
