The Delaware Medical Orders for Scope of Treatment (DMOST)  program is designed to improve the quality of care people receive at the end of life by translating patient/resident goals and preferences into medical orders. It is important to note that at this date (December 2013) there is no sanctioned form in use in the State of Delaware.  The old MOLST form, introduced a couple of years ago, was discontinued by order of the Director of the Delaware Division of Public Health citing legitimate concerns around a lack of supporting legislation.

DMOST is based on communication between the patient/resident, Health Care Agent or other designated decision-maker and health care professionals that ensures informed medical decision-making.

Honoring patient preferences is a critical element in providing quality end-of-life care. To enable physicians and other health care providers to discuss and convey a patient’s wishes regarding cardiopulmonary resuscitation (CPR) and life-sustaining treatment, this coalition is working to create statute and regulations that can be used statewide by health care providers and facilities as the legal equivalent of an inpatient Do Not Resuscitate (DNR) form.

DMOST is intended to provide a single document that would function as an actionable medical order and could transition with a patient through all health care settings. It is intended that the form will be transported with the patient between different health care settings in order that their wishes for life-sustaining treatment and CPR will be clearly indicated.