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A Medical Order for Scope of Treatment (MOST) is a medical order that identifies one of six designations for scope of treatment.
These designations provide direction on adult resuscitation status, critical care and medical interventions. Completed by the Most Responsible Practitioner (MRP), A MOST is based on Advance Care Planning and conversations with a capable adult about their goals of care - or if the adult is incapable, their Substitute Decision Maker (SDM).
MOST has replaced “No CPR orders” in acute and long-term care. MOST is valid in all care settings including community and honoured by the BC Ambulance Service. The BC No Cardiopulmonary Resuscitation form also remains valid.
Ideally, a MOST is completed following Advance Care Planning and goals of care conversations with patients and their families.
MOST clarifies the intent of treatment and helps health care providers deliver care that aligns with the adult's values, goals and health conditions, minimizing unnecessary or unwanted treatment.
While MOST does not replace the consent process required at the time of care, it can help to focus discussion on what is appropriate and desired care for the individual adult. MOST orders can help to ensure that substitute decision makers and health care providers are following the legal duty to provide care that is desired and refrain from initiating undesired care.
Watch this video below to see an example of how a family might work with a loved one's care team to start discussing how to complete a MOST.
If the adult is:
MOST Pamphlet
Is CPR Right for Me?
To order copies contact printing@islandhealth.ca
Printing codes:
#9-90581 MOST Lanyard Card
#9-90580 MOST Pamphlet
#9-90579 CPR Pamphlet
If you need more information please contact: MOST@islandhealth.ca