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Margaret supplied the attached the on the full Q & A from the NYSBA website.
Beth Talia found some useful questions and answers on this subject on a New York State Bar website. Here are a few applicable answers on the subject of the continuing “enforceability” of a MOLST upon discharge to home or other facilities. (I have also attached the full Q & A from the NYSBA website.)
Q - If a patient is admitted to a hospital with a DNR order that was issued in another hospital or nursing home or a nonhospital DNR order, can the attending physician issue an order to continue the DNR order?
A - The order that arrived with the patient remains effective until an attending physician examines the patient. That physician must then continue the order, unless the physician determines that the order is no longer appropriate or authorized. In deciding whether the order is still appropriate, the physician should consider whether the difference in response time to a cardiac arrest in the hospital might mean that the prognosis following CPR for the patient would be different, and whether a discussion with the decision-maker for the non-hospital order is warranted. Before canceling the order, the attending physician must make reasonable efforts to notify the person who made the decision. If such notice cannot reasonably be made prior to canceling the order, the attending physician must make such notice as soon as reasonably possible after cancellation. (Revised September 8, 2010).
Q - When a patient in a hospital with DNR order is transferred to a nursing home, does the nursing home need to get the resident's or surrogate's consent again to re-enter the DNR order? Will the nursing home ever have to get that consent?
A - The FHCDA provides that the attending physician at the nursing home can enter the DNR order without having to get another consent. The nursing home will never have to get that consent, unless the DNR order is revoked or suspended, and the issue is whether to enter it again.
Q - If a patient is admitted to a hospital with a non-hospital DNR order (including a MOLST form), or with a DNR order that was entered at another facility, can that be honored even if the patient had consented to it prior to the current hospitalization?
A - Yes. The provisions governing non-hospital DNR orders and inter-institutional transfers obligate the hospital to honor such orders. Hospital emergency services personnel may disregard a nonhospital order not to resuscitate if they believe in good faith that consent to the order has been revoked, or that the order has been cancelled; or if family members or others on the scene (other than such personnel) object to the order and physical confrontation appears likely; and hospital emergency services physicians may direct that the nonhospital order not to resuscitate be disregarded if other significant and exceptional medical circumstances warrant disregarding the order. If the patient is admitted, the medical orders to withhold life-sustaining treatment remain effective until an attending physician examines the patient, whereupon the attending physician must continue the orders, unless the physician determines that the order is no longer appropriate or authorized. There is no requirement to secure another consent from the surrogate. (Added September 8, 2010).
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