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Legal Notes

Massachusetts MOLST Form, Massachusetts Health Care Proxy, & Living Wills – explanations of these important medical documents

The Massachusetts MOLST Form, the Massachusetts Health Care Proxy, and a Living Will are three very important documents necessary for health care planning. There are similarities between these health care documents, but each document has specific purposes. The MOLST Form and Living Will are primarily used for end-of-life decisions. A Health Care Proxy is recommended for every legal adult as soon as they turn eighteen years old.

MOLST: Medical Orders for Life Sustaining Treatment

MOLST stands for Medical Orders for Life Sustaining Treatment. It is a medical document best suited for persons who are currently medically frail, have an advanced illness, a progressive illness, or a serious injury. It is also suitable for persons who may require a Do Not Resuscitate or Comfort Care form because of their present serious medical condition. It can only be signed either by an individual who has the mental capacity to make their own decisions based on their present medical condition, or their named health care agent in their Health Care Proxy on their behalf if they are mentally or physically incapacitated and their Health Care Proxy is invoked. In addition to being signed by the individual, or their health care agent, their physician also signs the MOLST form. It is not a legal document, which means it is advisory but not enforceable.

Massachusetts Health Care Proxy

The Massachusetts Health Care Proxy is a legal document. The Massachusetts Health Care Proxy law allows individuals to prepare a document naming a health care agent to make their medical decisions for them should they ever become incapacitated and thus unable to make their own medical decisions. A Health Care Proxy is strongly recommended for every person age eighteen and older. It is signed by the individual in the presence of two witnesses. Preparing for possible mental and/or physical incapacity is a subject matter not only for older adults to give serious consideration. Even young adults can become seriously ill or severely injured and become mentally and/or physically incapacitated. If an incapacitated person with a serious illness or injury has not signed a valid Health Care Proxy, a court proceeding naming a legal guardian is required so the court appointed guardian can have the authority to make all the medical decisions for that incapacitated person. This can be costly and takes time.

Living Wills

Living Wills, although not legally recognized in Massachusetts, are strong evidence of a person’s intentions as to the withholding or withdrawal of treatment for end-of-life decisions. These intentions can be incorporated within the Health Care Proxy itself or can be spelled out in a separate document attached to the Health Care Proxy. A Living Will gives your health care agent clearer directions to guide your named health care agent to act on your behalf for those medical decisions.

For more information and a toolkit including a Health Care Proxy form, go to Honoring Choices Mass. MOLST info and forms are here.

The views expressed in this column represent general information. To address your particular and specific needs consult your own attorney. If you need help with referral to an attorney, contact the Franklin County Bar Association at (413) 773-9839 or the Worcester County Bar Association at (978) 752-1311. Elder law resources may be found through the National Academy of Elder Law Attorneys, Massachusetts Chapter, or 617-566-5640.

Community Legal Aid (CLA) provides legal services free to people age 60 and older for civil legal matters with an emphasis on access to health care coverage (MassHealth and Medicare) and public benefits as well as tenants’ rights. A request for legal assistance can be made by phone at 413-774-3747 or toll-free 1-855-252-5342 during their intake hours (Monday, Tuesday, Thursday, and Friday from 9:30 a.m. to 12:15 p.m. and Wednesday from 1:30 p.m. to 4:15 p.m.) or any time online.