law tries to help people who want to plan for medical situations
when they might not be able to speak for themselves. The law
also encourages health care professionals to give the best possible
care to people with advanced illness. This page offers resources
about Maryland's Health Care Decisions Act and related law. It
also includes information about the Attorney General's
initiatives and activities in other areas of Health Decisions Policy.
access most of the documents on this page, you will need a reader
such as Adobe Acrobat. Click for instructions on downloading
a free copy of Acrobat
Reader to your computer.
What's New in
Health Decisions Policy?
1. Medical Orders for Life-Sustaining Treatment (MOLST) Form
The Governor recently approved legislation passed during the 2011 legislative session that authorizes the development of a Medical Orders for Life-Sustaining Treatment form (“MOLST” form) to better implement the provisions of the Health Care Decisions Act. The Attorney General's Office has worked closely with the Department of Health and Mental Hygiene, the State Advisory Council on Quality Care at the End of Life, and the Maryland Institute for Emergency Medical Services Systems to help them develop a MOLST form. Although not an advance directive, the MOLST form will allow a patient a complete range of options for their care, from choosing all available life-sustaining treatments to limiting or refusing those treatments. The MOLST form will simplify the process for health care providers and help to avoid errors by creating one standardized form to be used across health care settings.
The MOLST form is modeled on the Physician's Orders for Life-Sustaining Treatment (POLST) form in use in some states, which form has been shown in studies to significantly increase the level of compliance with patients' wishes for their care at the end of life. It is hoped that the MOLST form will have the same positive impact in Maryland in helping to insure that patients' wishes for their care are honored.
The Attorney General's Office will continue to work with other state agencies to provide training regarding the use of the MOLST form. In consultation with the Attorney General's Office, the State Advisory Council on Quality Care at the End of Life, and the Maryland Institute for Emergency Medical Services Systems, the Department of Health and Mental Hygiene has established a website containing educational materials regarding the MOLST form and information on upcoming training programs. The link to the MOLST website is: http://marylandmolst.org
Report on Hospice Care, Palliative Care and End of Life Counseling
At the request
of the Maryland General Assembly's Senate
Finance Committee and House Health and Government Operations Committee,
the Attorney General's Counsel for Health Decisions Policy
formed a workgroup to study and make recommendations related to
end-of-life counseling and hospice care. The workgroup consisted
of persons representing a wide variety of agencies, organizations,
and points of view. The workgroup met monthly from July through
December, 2009, and agreed to common goals in improving the quality
of end of life counseling and care at the end of life. The workgroup's
findings and recommendations are contained in this report.
3. The Life Sustaining Treatment options form has been released
A version of
the form in Spanish is available here.
Attorney General's Office has developed a wallet
card that you
can use to document the location of your Advance Health Care
Directive. Click here
to get the card.
Health care professionals and facilities, their legal counsel
and others interested in health care decision making may wish to
visit the website marylandadvancedirectives.com. This website is
give practical guidance to health care professionals and facilities
in interpreting and implementing the laws regarding health care decisions
by providing legal text, links to official opinions, informal guidance,
forms, guidelines, tools and references. While this material is an
educational resource only and is not a substitute for obtaining legal
advice, it contains information that can be considered as health
care professionals and facilities make decisions about how they implement policies
on health care decision making.
The New Life-Sustaining Treatment Options Form (Replacing the
Plan of Care Form)
new Instructions on Current Life-Sustaining Treatment Options
(“LST Options”) form came into use on
April 1, 2008. Click
here for the form. Click
here for the regulations governing its use. Three
Explanatory Guides for the LST Options form are now available:
State Advisory Council on Quality Care at the End of Life and
the Maryland Health Care Commission have issued a joint report
on pediatric palliative care. The report, “Study
of Health Care Services for Children with Life-Threatening Conditions,” discuses
the needs of these children, the current situation in Maryland,
projects on pediatric palliative care in other states, and policy
Advisory Council on Quality Care at the End of Life Meeting
The next meeting of the State Advisory Council on Quality Care at the End of Life will take place on January 30, 2014 from 10 am to 12 noon at the Department of Aging, 301 West Preston Street, Room 1007, Baltimore, Maryland 21201.
New palliative care guidelines released:
The National Consensus Project for Quality Palliative Care has
released revised Clinical Practice Guidelines for Quality Palliative
Care, Second Edition. The eight domains-such as physical, psychological,
social, spiritual, cultural, and ethical and legal aspects of care-remain
the same but the panel clarified content in the original document,
making it more inclusive and expansive to all settings that provide
palliative care. In addition, some sections have been further developed.
Consensus project participants hope the guidelines will serve as
a blueprint from which to build optimal palliative care. National
Consensus Project for Quality Palliative Care Consortium Organizations
include the American Academy of Hospice and Palliative Medicine,
the Center to Advance Palliative Care, the Hospice and Palliative.
The link to the guidelines is http://www.nationalconsensusproject.org/guideline.pdf