Council presses to restore comfort language and simplify wording in goals-of-care form

The MOLST Advisory Council spent substantial time revising language on the goals-of-care form. Dr. Shapiro said the updated form had removed a line that had previously ended each goal with "symptom management for comfort," and she urged that language be restored.

"Everyone deserves to be comfortable regardless of their goals of care," Dr. Shapiro said, asking the council to reinstate comfort-focused wording. Members debated wording across the three selectable options (full treatment, selective treatment, and comfort-focused treatment) and discussed ways to keep each option concise while still clarifying that all choices include symptom management for comfort.

Suggestions that gained support included placing a short, clear sentence above the selection list (for example, "All selections include symptom management for comfort") to avoid repetitive long lines, and replacing the header "Goals of treatment" with "Goals of care" to align with common parlance. Members also proposed removing the adjective "medical" from phrases like "limitations to medical treatment" to ensure palliative surgical interventions would not be unintentionally excluded.

Council members agreed that training slides explaining the revised language should be re-recorded where necessary; Melia said she would convert the agreed edits into a form and circulate the revised slide for review after the meeting.

The group asked staff to check the form's reading grade level and to circulate draft language for final edits before publication or training re-recording.