DNR Orders and POLST/MOLST Forms

For most healthy adults, an advance directive is enough. For those with serious illness or advanced frailty, these more specific medical orders often become relevant too.

What does DNR actually mean?

A DNR (Do Not Resuscitate) order specifically addresses one situation: whether you want CPR performed if your heart stops or you stop breathing. It doesn’t address other medical decisions on its own.

What is a POLST or MOLST form?

A POLST (Physician Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment) - the specific name depends on your state - is a more comprehensive, physician-signed medical order. It typically covers:

• CPR preferences (similar to a DNR)
• Preferences about hospitalization and levels of medical intervention
• Feeding tube and other life-sustaining treatment preferences

Because it’s a signed medical order rather than a general statement of wishes, it’s meant to be immediately followed by emergency responders and medical staff in real time.

How is this different from an advance directive?

An advance directive is a legal document expressing your wishes generally; a POLST/MOLST form is an actual physician-signed medical order, meant to be immediately followed by emergency responders and medical staff, not just a statement of preference.

Do I need a POLST/MOLST form if I’m generally healthy?

Generally no - these forms are typically recommended for people with a serious illness or advanced frailty, where specific, immediately actionable orders are more relevant than a general advance directive. They’re not typically necessary for otherwise healthy adults, who are usually well served by a standard advance directive instead.

How do I get one?

A POLST/MOLST form requires a conversation with, and signature from, your doctor or another qualified healthcare provider - it’s not a form you complete entirely on your own, unlike a standard advance directive.

For why these forms matter at the moment of death at home, see being with someone at the moment of death.

For how these orders relate to medical aid in dying, see hospice and medical aid in dying.

Availability and exact naming (POLST vs. MOLST vs. other state-specific names) vary by state. Talk to your doctor about whether this is appropriate for your situation.