Advance Directives
Health Care Proxy
Adults in new York State have the right to accept or refuse medical treatment, including life-sustaining treatment. You have the right to request or consent to treatment, to refuse treatment before it has started and to have treatment stopped once it has begun.
You may wish to plan in advance to make sure that your wishes about treatment will be followed if you become unable to decide for yourself for a short or long period of time. If you do not plan ahead, family members or other people close to you may not be allowed to make decisions for you and follow your wishes.
In New Yrok State, appointing someone you can trust to decide about treatment if you become unable to decide for yourslef is the best way to protect your treatment wishes and concerns. You have the right to appoint someone by filling out a form called a Heatlh Care Proxy.
If you have no one you can appoint to decide for you, or do not want to appoint someone, you also can give specific instructions about treatment in advance in what is commonly referred to as a Living Will.
It is important to understand that general instructions about refusing treatment, even if written down, may not be effective. Your instructions must be clear and cover the treatment decisions that must be made. For example, if you just write down that you do not want "heroic measures," the instructions may not be specific enough. You should say the kind of treatment that you do not want, such as a respirator or chemotherapy, and describe the medical condition when you would refuse the treatment, such as when you are terminaly ill or permanently unconscious with no hope of recovering. You can also give instructions orally by discussing your treatment wishes with your doctor, family members or others close to you.
Information on designating a Health Care Proxy and creating a Living Will and the New York Forms for each, Click Here.
Do Not Resuscitate (DNR) Orders
Your right to decide about treatment includes the right to decide about cardiopulmonary resuscitation (CPR). CPR is emergency treatment to restart the heart and lungs when your breathing or circulation stops.
Sometimes doctors and patients decide in advance that CPR should not be provided, and the doctor gives the medical staff an order not to resusciatate (DNR). If your physicial or mental condition prevents you from deciding about CPR, someone you appoint, your family members or others close to you can decide.
To enable physicians and other health care providers to discuss and convey a patients' wishes regarding cardiopulmonary resusciation (CPR) and life-sustaining treatment, the Department of Health has approved a physician order form, the Medical Orders for Life Sustaining Treatment (MOLST) that can be used statewide by health care providers and facilities as the legal equivalent of an inpatient Do Not Reususciatate (DNR) form.
The MOLST form is a bright pink medical order form signed by a New York State licensed physician that communicates patient wishes regarding life-sustaining treatment to health care providers. These valid medical orders must be followed by all health care professionals in all sites of care, including the community.
The form includes medical orders and patient preference regarding:
- FCPR (Caridiopulmonary resuscitation)
- Intubation and mechanical ventilation
- Artificial hydration and nutrition
A properly completed MOLST form contains valid medical orders signed by a licensed New York State physician. It is not intended to replace traditional Advance Directives like the Health Care Proxy and Living Will.
Copies of the MOLST form and the supplemental documentation forms for adults who lack capacity or meet "exceptional circumstances" and minors are available by using the order form available from the Excellus BC/BS website. Click Here for Order Form.
Should you have questions for the Department of Health regarding MOLST, please send them to molst@health.state.ny.us.
