2019 the State of South Dakota developed a standardized form, MOST, to complement living will and Durable Power of Attorney paperwork for people to explain their wishes if they are at or near the end of their life. (Senate Bill 118). This form can be used in all health-care settings and nursing facilities in South Dakota. Similar forms, the POLST, have been successfully used in other states and the Faulkton Senior Living Center for many years.

The MOST form specifically states, “The duty of medicine is to care for patients even when they cannot be cured. Physicians, nurse practitioners and physician assistants, and their patients must evaluate the use of technology at their disposal based on available information. Judgments about the use of technology to maintain life must reflect the inherent dignity of the patient and the purpose of medical care. Everyone is to be treated with dignity and respect.” https://doh.sd.gov/providers/most/

MOST is a 2-page form, which is reviewed by each patient with a terminal illness or their representative. It is signed by your medical provider, MD, DO, PA, or NP. It addresses CPR, medical interventions, such as life support, hospitalization or ICU placement, artificial fluids and nutrition. It can be revoked simply by making an X across the parts to be revoked and writing VOID on those parts, with the correct patient or representative signature.

“The purpose of the MOST order form is to ensure all individuals who are facing a terminal condition have the opportunity to discuss their condition with their medical provider and have the opportunity to express their values and preferences for life-sustaining treatment documented in a medial order. South Dakota MOST does not replace an advance healthcare directive (durable power of attorney for healthcare or living will). Both documents work together in a patient-centered approach to honor the values, wishes and goals of each patient”. https://sdaho.org/MOST/

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