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Committee flags revocation disputes over MOLST orders; directs written scenario for legal review and July meeting discussion
Summary
Advisory members raised recurring concerns about situations where a patient's executed MOLST conflicts with a legally authorized representative's wishes, discussed probate court and attorney‑general pathways, and tasked staff to draft a focused question for legal review ahead of the July 8 meeting.
Advisory members flagged a recurring, practical problem: what to do when an executed MOLST form is presented at the bedside but a legally authorized representative attempts to revoke or override the patient’s stated orders.
The group discussed the legal and operational complexity at length. Participants said the statute references probate for disputes about interpretation, and some members noted DNR regulations allow a legally authorized representative to revoke a DNR order in Connecticut. Several members emphasized that most MOLST forms will be followed without dispute, but that clarity is needed for rare, high‑stakes cases that involve EMTs and emergency department staff.
Committee members discussed options for next steps: asking Judge Darby (a probate judge and advisory member) for guidance, consulting the probate court administrator’s office (Judge Beverly Scribe Carr Hollis was named), or requesting a formal opinion from the attorney general’s office to provide statewide legal clarity and potential immunity guidance for clinicians and EMS providers.
The committee agreed on a process: subcommittee members will draft a concise written scenario describing two common operational settings (prehospital and hospital) in which a MOLST is presented and a legally authorized representative seeks to change directives. That written scenario will be reviewed with Joel and Dr. Kamen for prehospital nuance, circulated to the larger advisory council, and placed on the July 8 agenda. Department of Public Health staff said formal attorney‑general opinions can be requested but noted the process can take months; starting with Judge Darby was suggested as a near‑term step.
Members reiterated training must emphasize identification of advance directives and whether designated health‑care representatives are aware and in agreement to reduce the chance of dispute. The group did not change any operational guidance at the meeting; instead they set follow‑up steps to seek legal clarification and to develop FAQ language addressing revocation scenarios for clinicians and EMS.
