New Mexico MOST Form and DNR Orders: What You Need to Know
New Mexico MOST Form and DNR Orders: What You Need to Know
Checking "do not resuscitate" in a living will template won't stop paramedics from performing CPR if you go into cardiac arrest at home. That's because a living will is a legal planning document — not a medical order. In New Mexico, the documents that first responders are trained and required to follow are the MOST form and the EMS DNR order.
Understanding the difference between legal directives and clinical orders can be the difference between your wishes being honored or overridden in a crisis.
MOST Form: Medical Orders for Scope of Treatment
New Mexico uses MOST instead of POLST (Physician Orders for Life-Sustaining Treatment). The function is the same — it translates a patient's treatment preferences into active medical orders — but New Mexico's version has its own specific requirements.
Who Should Have a MOST
MOST is intended for people who are seriously ill, medically frail, or facing a terminal or life-limiting diagnosis. It's not designed for healthy adults doing general advance care planning — that's what an advance directive is for.
What the MOST Covers
The form addresses three critical clinical decisions:
- CPR status — Attempt resuscitation, or DNR (do not attempt resuscitation)
- Level of medical intervention — Full treatment, limited interventions, or comfort measures only
- Artificial nutrition — Long-term feeding tube, trial period, or no artificial nutrition
These three decisions must be clinically consistent. Requesting "comfort measures only" for medical intervention but "full CPR" creates a contradictory order that confuses emergency responders.
Execution Requirements
A MOST must be signed by both:
- The patient (or their legally authorized healthcare agent/surrogate)
- A licensed physician (MD/DO), Advanced Practice Nurse (APN), or Physician Assistant (PA)
The form is traditionally printed on heavy 65 lb "Terra Green" paper — that specific color makes it immediately recognizable to paramedics and ER staff. Ask your physician's office or hospital to print it on the correct cardstock.
Where to Keep It
Place the completed MOST in a visible location — typically on the refrigerator door, near the front entrance, or on a bedside table. First responders are trained to look for the distinctive green form. If it's filed away in a drawer, they may not find it before starting treatment.
EMS DNR Order
The EMS DNR is more focused than MOST. It addresses one specific situation: cardiac or respiratory arrest in a pre-hospital setting.
What It Does
When paramedics arrive at a scene and a patient has no pulse or isn't breathing, they begin CPR and advanced life support by default. A valid EMS DNR order tells them to withhold or stop resuscitation efforts and allow a natural death.
Execution Requirements
Like MOST, an EMS DNR must be signed by both the patient (or their authorized surrogate) and a licensed physician, APN, or PA. Under NMAC 7.27.6, EMS personnel are legally required to honor it.
Display and Identification
Two options for ensuring EMS personnel see your DNR status:
- Paper form — Keep the signed original in a white envelope with "EMS DNR Order Inside" prominently displayed. Place it where first responders will find it immediately.
- MedicAlert identification — Wear an approved MedicAlert bracelet or necklace. This is particularly important if you're outside your home when an emergency occurs.
How MOST and DNR Differ From an Advance Directive
| Feature | Advance Directive | MOST / EMS DNR |
|---|---|---|
| Type | Legal planning document | Active medical orders |
| Created by | You (the patient) | Your physician + you |
| When it's used | When you lack decision-making capacity | Immediately, in any medical setting |
| Who follows it | Your healthcare agent, then medical team | EMTs, paramedics, ER staff |
| CPR coverage | No — only guides future decisions | Yes — directly controls resuscitation |
An advance directive tells your healthcare agent what you want. A MOST or DNR tells the medical team what to do — right now, without waiting for an agent to be contacted.
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Getting These Forms
Your physician, hospice team, or hospital palliative care department can provide both forms. The MOST is also available through the New Mexico Department of Health. Neither form requires a lawyer or a filing fee.
Why You Need Both an Advance Directive and Clinical Orders
Your advance directive appoints a healthcare agent who can authorize a MOST or DNR on your behalf if you lose capacity. Without that appointment, obtaining these clinical orders after incapacity requires navigating the statutory surrogate hierarchy — a process that can stall if family members disagree.
The New Mexico Advance Directive & Living Will Kit includes a MOST/EMS DNR reference guide that explains how clinical orders connect to your legal planning documents, ensuring your appointed agent can coordinate everything seamlessly.
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