Health Care Proxy vs. Living Will vs. Do Not Resuscitate (DNR) vs. MOLST

This entry was posted on May 2, 2016

A Health Care Proxy is a legal document in New York state which allows you to appoint someone to make health care decisions on your behalf if you lose the ability to make decisions for yourself.

New York state provides a standard form in the law. This standard form is widely used by attorneys, physicians and hospitals. The blank Health Care Proxy form from New York state can be found on the Internet at:

https://www.health.ny.gov/forms/doh-1430.pdf

There is an optional section on the form with blank lines for additional instructions. We have found that most new clients who come to our office either don't have a Health Care Proxy or have one with the optional section for additional instructions left blank.

Under New York law, your Health Care Proxy agent does not have the authority to make health care decisions for you about artificial nutrition and hydration (nourishment and water provided by feeding tube and intravenous line) unless you have made your wishes known to your agent.

As a practical matter, most hospitals and physicians will be very reluctant to follow an agent's instructions without the necessary proof of your wishes. Therefore, it is critical that you make your wishes known in this optional section of your Health Care Proxy.

Living Will

A Living Will is basically a statement of your medical treatment wishes if you become incapacitated and also typically includes your wishes regarding termination of life support. Unlike a Health Care Proxy, there is no standard form for a Living Will.

A Living Will is not a legal document specifically authorized by New York statute. It does, however, provide evidence of your wishes that can be reviewed by a court.

There are advantages and disadvantages to having a Living Will. On the one hand, a Living Will provides guidance to your appointed Health Care Proxy agent. On the other hand, a Living Will can create possible ambiguity for others to use to challenge decisions made by your Health Care Proxy agent. A Living Will needs to be interpreted and sometimes this can lead to conflict between family members and medical professionals.

Do Not Resuscitate Order (DNR)

A DNR is a legal document authorized by New York statute that you can sign instructing medical professionals not to perform cardiopulmonary resuscitation (CPR) treatment to restart your heart or lungs when your heartbeat or breathing stops.

Medical Orders for Life-Sustaining Treatment (MOLST)

A MOLST form is authorized by New York law and must be completed by a health care professional and signed by a New York State licensed physician to be valid. This is a form that outlines in great detail your medical treatment wishes including termination of life support. This form becomes part of your medical records. A MOLST form is typically used for immediate decisions about your current treatment. A Health Care Proxy and Living Will are typically used to cover your wishes for the future.

New York State has an excellent website outlining all of these advance directive options along with sample forms:
http://www.ag.ny.gov/sites/default/files/pdfs/publications/Planning_Your_Health_Care_in_Advance.pdf