MOST and DNR Forms - the other side of Advance Directives
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).
Hi,
Really a great post. And I say Thanks 100 times for this blog entry. Hope the DNR and MOST forms can be useful for the health care plans. Nice post.
Thank you
Rachel.
Livingwillchoice
Thank you for raising the most important point in and advance directive and that is the durable power of attorney for healthcare. It is of utmost importance that when a living will is filled out that the wishes are discussed with your DPA.
Again, Thank you,
Frank
Hello... who can tell me the liability for siblings who are disagreeing over DNR vs. Full Code status for a nursing home resident????
If the majority of siblings want to change the status to DNR, but one with a staunch ideology refuses; if they go ahead and change it, can that one sibling sue his siblings? Can that person also sue the nursing home?
HOw do the siblings who are concerned about the intrusive pain caused by resuscitation demanded in a Full Code status protect themselves if they act in the parent's best interest by changing the Full Code to a DNR without the agreement of the dissenting sibing?
RESPONSE: Given the extreme importance of this issue, I recommend that you consult with an attorney specializing in such issues to help advise you.
I was wondering what would happen in a hospital setting in the event of an emergency where no advance directive or POA is available? What would the hospitals do and how would they decide?
RESPONSE: See http://www.ncga.state.nc.us/EnactedLegislation/Statutes/HTML/BySection/Chapter_90/GS_90-322.html