The AMA Code of Medical Ethics Opinion 5.3 Withholding or Withdrawing Life-Sustaining Treatment
How to have difficult conversation regarding life sustaining treatment.
Center to Advance Palliative Care (CAPC) COVID-19 Response Resources
The CAPC has a whole host of resources in their toolkit, including communication scripts and conversation videos, symptom management protocols, palliative care team tools, and using telehealth resources, among others.
Vital Talk: COVID Ready Communication Playbook
Based in Seattle, Vital Talk crowdsourced this playbook to provide some practical advice on how to talk about some difficult topics related to COVID-19. Building on their experience studying and teaching communication for two decades, they’ve drawn on their networks to crowdsource the challenges and match them with advice from some of the best clinicians they know.
Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life
Authored by the Committee on Approaching Death: Addressing Key End of Life Issues of the IOM (Institute of Medicine).
PubMed Collection of Abstracts - Emergency Care and Critical Care
A list of abstracts for 18 articles on how to have these difficult conversations, with particular attention to emergency care and critical care
Medical Orders for Life-Sustaining Treatment (MOLST)
Honoring patient preferences is a critical element in providing quality end-of-life care. To help physicians and other health care providers discuss and convey a patient's wishes regarding cardiopulmonary resuscitation (CPR) and other life-sustaining treatment, the Department of Health has approved a physician and nurse practitioner order form (DOH-5003), Medical Orders for Life-Sustaining Treatment (MOLST) , which can be used statewide by health care practitioners and facilities. MOLST is intended for patients with serious health conditions who:
Want to avoid or receive any or all life-sustaining treatment;
Reside in a long-term care facility or require long-term care services; and/or
Might die within the next year.
Completion of the MOLST begins with a conversation or a series of conversations between the patient, the patient's health care agent or surrogate, and a qualified, trained health care professional that defines the patient's goals for care, reviews possible treatment options on the entire MOLST form, and ensures shared, informed medical decision-making. Although the conversation(s) about goals and treatment options may be initiated by any qualified and trained health care professional, a licensed physician or nurse practitioner must always, at a minimum: (i) confer with the patient and/or the patient's health care agent or surrogate about the patient's diagnosis, prognosis, goals for care, treatment preferences, and consent by the appropriate decision-maker, and (ii) sign the orders derived from that discussion.