The Other Instructions section of the MOLST provides for additional medical orders and instructions about trials that are discussed with the physician or nurse practitioner or physician assistant (as of June 17, 2020).
Other medical treatments not listed on the MOLST are patient specific. These would include, but not be limited to:
A trial of life-sustaining treatment may be ordered if the physician or nurse practitioner or physician assistant (as of June 17, 2020) agrees it is medically appropriate. A trial is used to determine if there is benefit to the patient and is based on the patient’s current goals for care. If a life-sustaining treatment is started but turns out not to be helpful and does not meet the patient’s goals for care, the treatment can be stopped.
A trial is patient-specific. Be detailed in describing the goals and document the details of the trial in “Other Instructions”.
There is no medical, legal or ethical distinction between withholding and withdrawing life-sustaining treatment. A decision to withdraw ventilator support should be based on the patient’s goals. If there was a distinction, patients would not opt to opt for a trial of therapy.
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