Medical order for scope of treatment

It is a doctor’s order based on advance care planning conversations that explore your values, goals, and the range of treatments available. Once decisions are made your doctor can record this on the medical order for scope of treatment or MOST form. This helps care providers honour what is important to you. You will be given a copy so you can communicate your wishes in all settings of care.

The medical order for scope of treatment form provides orders for:

• Cardiopulmonary resuscitation (CPR) should your heart and breathing stop. CPR is when we try to restart your heart and your breathing with machines and chest compressions. It may not be right for you as it cannot change the effects of chronic illness.
• Medical treatments can focus on comfort goals or be very aggressive and include intensive care. Your doctor(s) can recommend what is right for you.

Many people lose the ability to decide about their own health care when they become very ill. If you cannot speak for yourself or make health care decisions, the MOST order can direct your care.

You are always asked to give your own consent for health care treatment as long as you are able.

We suggest you have a ‘scope of treatment’ order if you:

• Live with a chronic or life-limiting illness
• Plan to move into a supported care facility such as assisted living or long term care
• Have nurses or other health care workers caring for you at home
• Want to document plans about future medical care and treatment

A ‘scope of treatment’ order is an option. You do not have to have one to receive health care services. It does not apply to children.

• What is important to you
• Your health and what it might look like in the future and the types of treatments that might be effective
• Options for care at end of life
• Who will speak for you if you cannot speak for yourself (substitute decision maker)

Talking with your doctor can help you understand your choices and plan for what is best for you. It is best to include your family so they are able to support you.

Yes, it can be changed at any time. It is good to review and update your ‘scope of treatment’ orders with your doctor at least once a year and if:

• Your health changes or
• You go to hospital or
• You move into a supported care facility such as assisted living or long term care

Many hospitals keep a copy of your form. However it is recommended that you keep a copy and make others aware of it. This is important if:

• You go into hospital or
• You go to the Emergency Department or
• You move into a supported care facility such as assisted living or long term care or
• You go to any medical appointment

When you leave the hospital, you are given your form to keep. Keep it on your fridge at home. Tell your family it is there.

In B.C., a substitute decision maker is a family member or close friend who has the legal right to make health care decisions on your behalf if you cannot speak for yourself. It is important that your substitute decision maker knows about the care you want.

Learn more about advance care planning.

• Medical order for scope of treatment (MOST) brochure