MOST is an acronym for “medical orders for scope of treatment” and is specific to New Mexico.
A MOST form is a great tool for outlining patients’ wishes for medical interventions and end-of-life care when individuals have a serious or life-threatening illness. It consists of a set of medical orders which are integrated into the patient’s medical record and are signed by a health care professional, enabling all medical facilities where a patient is treated to know of the patient’s wishes if unable to communicate them.
Patients can indicate on the MOST forms whether or not they want to receive treatments such as:
- Cardiopulmonary resuscitation (CPR)
- Antibiotics
- Artificially administered nutrition and fluids
- Intubation
- Hospitalization wishes
Many people have advanced healthcare directives and do not feel they need the MOST forms. Advanced healthcare directives consist of a living will and powers of attorney. However, advanced healthcare directives are typically written many years before patients are nearing the end of their life and may not necessarily reflect the patient’s current wishes during a serious illness. MOST forms can be used in lieu of advanced healthcare directives or concurrently with advanced healthcare directives to accurately portray their most current wishes and medical circumstances.
Every adult, no matter what their age, should have advanced healthcare directives. Whereas, MOST forms are specifically designed for patients nearing the end of their life who are seriously ill or frail, are at an increased risk of hospitalization due to a current medical condition, or who have had multiple hospital visits over the past year and are declining in health.
Below is a comparison table showing the differences and similarities of MOST Forms and Advanced Directives.
| MOST Form | Advance Directive | |
| Type of document | Medical order | Legal document |
| Who completes? | Health care professional | Individual with attorney |
| Who needs one? | Any patients considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. | All competent adults |
| Is completion voluntary? | Yes | Yes |
| Appoints an agent? | Yes | Yes |
| What is communicated? | Specific medical orders | General wishes about treatment wishes |
| Can emergency personnel follow? | Yes | No |
| Ease in locating | Should be easy. Patient has original. Copy is in medical record. | May be difficult. Depends where individual keeps it and if they have told someone where it is, given a copy to agent, or to health care professional to put in his/her medical record |
| Periodic review | Health care professional is responsible for reviewing with patient or surrogate upon:
-transfer to a new facility -when there is a substantial change in patient’s medical condition; or -when patient’s goals of care or treatment preferences change |
Up to the individual about how often it is reviewed and/or updated. |
While there are areas in which the MOST form and the advanced healthcare directive overlap, it is important to understand when a MOST form is needed. If you or your loved one are healthy, competent adults, an advanced healthcare directive is all you need at this time. If you or your loved one have ongoing medical conditions, are in and out of the hospital multiple times a year, and are nearing the end of your life, consider working with your healthcare provider to fill out the MOST form and include in your medical records.
If you are needing to have your advanced healthcare directives done, contact your estate planning attorney or call our office at 505-872-0505 and speak to our intake specialist to meet with an attorney.
If you would like more information on MOST forms, please visit www.nmmost.org.