Patients’ preferences for life-sustaining treatment can and do need to change over time. But the current pandemic was making it difficult for some individuals to document their wishes on official forms. As a result, the state now directs emergency medical personnel to honor “Do not resuscitate” and other medical orders for life-sustaining treatment (MOLST) when clinicians document verbal consent from patients or their legal advocates. MOLST forms also address patients’ wishes regarding intubation and use of a ventilator, two elements of care for those most sickened by COVID-19.

Honoring Choices Massachusetts asked the state to allow for verbal consent to complete or revise a MOLST form when in-person consent is not possible, a change that went into effect last month. Its website has additional information and a sample of the protocol used by one medical center in the state to document a patient’s verbal consent.