In this episode, Tim explains the differences between a health care proxy, a living will, and medical orders for life sustaining treatment (MOLST).
Podcast Transcription:
WRVO Producer Mark Lavonier:
This podcast is part of the series Estate Planning Pro Tips, hosted by attorney Tim Crisafulli of Crisafulli Estate Planning and Elder Law, P.C. An estate planning, probate, and elder law firm serving clients throughout Central New York. A former school teacher, Tim explains complex legal subjects in an easy-to-understand way. The commentaries focus on essential aspects of estate planning, such as wills, trusts, asset protection, long-term care, and probate. And now here's Tim.
Tim Crisafulli:
When it comes to staying in control of healthcare decision-making, three documents come into play: a healthcare proxy, a living will, and medical orders for life-sustaining treatment, which is also known as the MOLST.
A healthcare proxy designates an agent and, ideally, a backup or two, who is authorized to make medical decisions for you in the event you cannot communicate your own wishes. Many people have an idea of who should be in charge, but unless a person’s wishes are properly documented in a valid healthcare proxy, New York State’s Family Health Care Decisions Act controls. That law ranks people who may make decisions on behalf of an incapacitated individual. In order, they are: a court-appointed guardian, a spouse or domestic partner, an adult child, a parent, an adult sibling, and finally, a close friend. As you can imagine, conflicts arise. For example, where the decision rests with an adult child, the act does not determine which one. If multiple adult children are in conflict, then the family may be off to court to decide an incapacitated parent’s fate.
Distinct from a healthcare proxy, a living will is a document that sets forth the treatment that an individual does and does not want in the event the individual becomes incapacitated. Common provisions address pain relief and setting forth the situations that warrant a transition from intervention—including surgeries and medications—to comfort care.
Last comes the MOLST, short for Medical Orders for Life-Sustaining Treatment. The first two words say it all: medical orders. The MOLST is a document created by a healthcare professional, not an attorney. This memorializes a patient’s wishes in actual medical orders, which are to be followed by paramedics and other healthcare professionals.
Remember: absent putting proper documents in place, a person’s healthcare decisions will be made by individuals chosen by the law. Those people may or may not be who the incapacitated person would have wanted, and their decisions may or may not reflect the incapacitated person’s wishes.
