End-of-Life Resources

Background
Legislation was enacted in 2007 bringing to fruition a three-year effort by the NCMS Ethical and Judicial Affairs Committee to develop a comprehensive portable physician order for seriously ill patients. The bill provided statutory recognition of the Medical Orders for Scope of Treatement or MOST form, which will facilitate its adoption across the state. Associate General Counsel Melanie Phelps and members of the Ethical and Judicial Affairs Committee worked closely with a committee of the NC Bar Association to craft and pass the legislation to clarify, update and synchronize NC laws addressing end of life, with the goal of promoting patient self-determination at the end of life.


New End-of-Life Legislation and Revised Documents

• "General Assembly Overhauls Advance Directive Laws," an article by Ken Burgess.
  
• Overview of House Bill 634: Get the specifics on the legislative changes that took effect October 1, 2007 with the passing of HB 634 - Advance Directives/Health Care POA
  
• House Bill 1372 and Organ Donation Changes
  
• New Statutory Living Will Form
  
• New Statutory Health Care Power of Attorney Form
  
  
• Medical Orders for Scope of Treatment (MOST) Form
  
  • Frequently Asked Questions Regarding MOST
    
  • Obtain a MOST form
    
    • Physicians and other health care providers: Beginning January 15, 2008, the MOST form will be available through the Office of Emergency Medical Services, North Carolina Department of Health and Human Services: http://www.ncdhhs.gov/dhsr/EMS/dnrmost.html
      
    • Patients or consumers: Since MOST is a medical order, the forms will be available to patients or their representatives only through physicians or health care facilities or agencies such as home health or hospice. If your physician or health care provider is not familiar with the MOST form, please ask your health care provider to contact the North Carolina Medical Society for additional information at www.ncmedsoc.org or email or call Melanie Phelps at mphelps@ncmedsoc.org or 919-833-3836.
  • View a sample MOST Form
    
  • Information about MOST: A New Portable Medical Order for North Carolina
    
  • Additional End-of-Life Efforts Across the Country: http://www.polst.org
    
  • Download the PractEssentials Podcast on MOST
    
  • Order the archived Webinar on the MOST form: PractEssentials offers 1-hour seminars called LunchTime Lessons over the internet on a variety of topics useful to medical practices and practice managers. These seminars are recorded and offered on CD. The CD includes a copy of the recorded webcast, the original presentation file, and any handouts provided. All archives are $50 and can be purchased by calling PractEssentials at 919-833-3836 or online at the NCMS Bookstore.
    
  
  
• Do Not Resuscitate Orders
  
  • DNR Sample Form
    
  • Obtain DNR Forms
    
    • Physicians or other health care providers: DNR forms are available through the Office of Emergency Medical Services, North Carolina Department of Health and Human Services: http://www.ncdhhs.gov/dhsr/EMS/dnrmost.html
      
    • Patients or consumers: DNR forms will be available to patients or their representatives only through physicians or health care facilities or agencies such as home health or hospice. Please ask your health care provider to contact the North Carolina Medical Society for additional information at www.ncmedsoc.org, email or call Melanie Phelps at mphelps@ncmedsoc.org or 919-833-3836, or contact the Office of Emergency Medical Services.
    
    
  • No Code or Do Not Resuscitate Orders
  
  
• Artificial Nutrition and Hydration
  
  • For Physicians:
    
    • Position Statement by the NCMS for Physicians
      
    • Long-Term Feeding Tubes: Ethical Issues in Physicians' Decision Making
    
    
  • For Patients & Family
    
    • Feeding Tube Information
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