Until recently, most end of life decisions were memorialized in a legal document known as a living will or an advance directive for health care. However, in the heat of an emergency moment, paramedics and EMTs often do not have the time or the training to parse through the details of a patients case and to consider legal documents. They are often presented with one or two critical issues, for example: the patient's heart being stopped or the patient not breathing, and time is of the essence in those moments. Presented with one of these time sensitive scenarios, if the first responder is not aware of any medical orders to the contrary, they are legally obligated to work towards prolonging the patient's life.
A recent opinion piece in the New York Times covered the relatively newly developed Physician Orders concerning Life Support Treatment (POLST in many states) and Medical Orders concerning Life Support Treatment (MOLST as they are known in Maryland).
The POLST/MOLST are Medical Orders, prepared by the patient and his physician, that cover a number of decisions that could likely be involved in the patient's end of life. If a first responder is aware of a medical order that states that the patient does not wish to be resuscitated, then they know to not perform CPR or shock the patient.
An advance directive is still a critical legal document to possess, it appoints the people you want making decisions in the event that you are unable to, as well as serves as a beginning point for a discussion about a MOLST with your physician regarding your end of life care. For people who want to ensure that their end of life wishes are met, it is critical that they speak with their doctor about having a MOLST prepared.
For answers to a lot of other questions concerning the MOLST, the Maryland Attorney General's office published a Frequently Asked Questions and is accessible here.
Reference: http://opinionator.blogs.nytimes.com/2015/04/29/the-right-paperwork-for-your-end-of-life-wishes/
and
http://marylandmolst.org/docs/Guide%20for%20Patients%20and%20Caregivers%20May%202012.pdf
Holden & Campbell - Annapolis, Maryland Estate Planning Attorneys