BY TRACEY DRURY
Business First

Gov. David Paterson has signed into law a bill to help ensure that people's end-of-life wishes are followed regardless of whether they are at home, in a nursing home or any other nonhospital setting.

The new law, Medical Orders for Life Sustaining Treatment (MOLST), makes permanent and statewide a program piloted in Monroe and Onondaga counties aimed at seriously ill patients with advanced chronic illness and frailty. Patients complete the form after talking with their doctor to document the end-of-life care they prefer.

The MOLST form indicates whether the patient wants to be resuscitated or intubated and whether they want to be sent to the hospital or take medication, among other wishes. The law is based on a national model that has been shown to ensure that seriously ill patients' wishes are followed. New York is one of six states with a state-approved program.

Printed on bright pink paper, the MOLST form is intended to be easily identified by paramedics and will contain medical orders signed by patients' physicians.

The bill was spearheaded by Univera Healthcare's Dr. Patricia Bomba, vice president and medical director for geriatrics.

"Too often, people don't die in the setting of their choice, don't have advance directives in place, and many fear dying in pain and without dignity or control," she said in a prepared statement.

State Health Commissioner Dr. Richard Daine, in a statement, praised the bill.

"This will give patients more choices for end-of-life care. It expands patients' instructions beyond a do-not-resuscitate order into areas of intubation and medication, which many end-stage patients would like to control for themselves as much as possible," he said.

Before MOLST, the only nonhospital medical order that emergency medical service workers could directly follow was a do-not-resuscitate order, which indicated whether the patient wanted lifesaving treatment for a cardiac or respiratory arrest. The bill signed by Paterson July 8 amends public health law to also allow for MOLST, which includes other life-sustaining treatment.

The new law does not take the place of a living will or health-care proxy.

MOLST grew out of the Rochester-based Community-Wide End of Life/Palliative Care Initiative, formed in 2001, whose members were charged with improving end-of-life care in New York. In 2005, the state Department of Health approved MOLST for use in all health-care facilities in the state and as a pilot project for community use by emergency medical services providers in Monroe and Onondaga counties.