End-of-Life Discussion

Reviewing your end-of-life planning on a yearly basis, or as your condition changes, is a necessary and beneficial part of your health maintenance.

North Carolina is one of fifteen states allowing patients, families and their doctors the ability to formally prepare a single document that outlines a patient’s wishes for end-of-life care.  

The Medical Orders for Scope of Treatment (MOST) form is a single page medical order that is completed after thoughtful discussions between the patient, their family members and Healthcare Power of Attorney. Led by your physician or nurse practitioner, the MOST is designed to determine if a patient with advanced illness wants aggressive life-sustaining treatment, a limited intervention, or simply palliative or hospice care. The patient or Healthcare Power of Attorney signs the form, along with the healthcare provider, to indicate informed consent. Thereafter, if a patient becomes incapacitated, there are medical orders clearly outlining his or her wishes regarding end-of-life treatment.

The current Do Not Resuscitate (DNR) order has been an effective step in support of patients’ decisions, specifically about CPR. It may continue to be an important tool for some patient populations. A MOST, however, allows seriously ill patients to outline more comprehensive choices about their end-of-life care. This includes preferences regarding CPR, antibiotics, and artificial nutrition and hydration. Unlike the portable DNR, which tells healthcare providers that the patient does NOT want to be resuscitated, a MOST also includes options to receive other types and levels of treatment.

For more information and a video describing the MOST form, go to www.ncmedsoc.org/pages/public_health_info/end_of_life.html