2023 Delaware Code › Title 16 - Health and Safety › Chapter 25A. DELAWARE MEDICAL ORDERS FOR SCOPE OF TREATMENT ACT › § 2503A. Definitions.

§ 2503A. Definitions.
(a) “Advance health-care directive” means an advance health-care directive under Chapter 25 of this title, a durable power of attorney for health-care decisions, or any individual instruction or power of attorney for health care valid in the state where such document was executed or where the individual executing such document was a resident at the time that such document was executed that appoints an agent. Said document must have been executed by the individual authorizing the appointed agent to make decisions about the individual's health care when such individual no longer has decision-making capacity.
(b) “Decision-making capacity” means a patient's ability to understand and appreciate the nature and consequences of a particular health-care decision, including the benefits and risks of that decision and alternatives to any proposed health care, and to reach an informed health-care decision.
(c) “Delaware Medical Orders for Scope of Treatment” (DMOST) means a clinical process to facilitate communication between health-care professionals and patients living with serious illness or frailty whose health-care practitioner would not be surprised if they died within the next year or, if the patient lacks decision-making capacity, the patient's authorized representative. The process encourages shared, informed medical decision-making. The result is a DMOST form, which contains portable medical orders that respect the patient's goals for care in regard to the use of CPR and other medical interventions. The DMOST form is applicable across health-care settings, is reviewable, and is revocable.
(d) “Department” means the Department of Health and Social Services.
(e) “DMOST form” means a standardized document created or approved by the Department that is uniquely identifiable and has a uniform format or color, which:
(1) Is used on a voluntary basis by patients living with serious illness or frailty whose health-care practitioner would not be surprised if they died within the next year;
(2) Is not an advance health-care directive;
(3) Is not valid unless it meets the requirements for a completed DMOST form as set forth in this chapter;
(4) Is intended to provide direction to emergency care personnel regarding the use of emergency care and to health-care providers regarding the use of life-sustaining treatment by indicating the patient's preference concerning the scope of treatment, the use of specified interventions, and the intensity of treatment for each intervention;
(5) Is intended to accompany the patient, and to be honored by all personnel attending the patient, across the full range of possible health-care settings, including but not limited to the patient's home, a health-care institution, at the scene of a medical emergency, or during transport;
(6) May be reviewed or voided at any time by a patient with decision-making capacity or, if the patient lacks decision-making capacity, the patient's representative in accordance with the provisions of § 2511A of this title; and
(7) Must be signed by a health-care practitioner.
(f) “Emergency-care provider” means an emergency medical technician, paramedic, or first responder authorized under Chapter 97 of this title.
(g) “Health-care institution” means an institution, facility, or agency licensed, certified or otherwise authorized or permitted by law to provide health care in the ordinary course of business.
(h) “Health-care practitioner” means a physician or an individual licensed and authorized to write medical orders under Title 24 who is providing care for the patient or overseeing the health care provided to a patient and has completed all training required by the Department for individuals participating in the completion of a DMOST form. Over time, a patient's health-care practitioner may change.
(i) “Health-care provider” means an individual licensed, certified, or otherwise authorized or permitted by law to provide health care in the ordinary course of business or practice of a profession. A health-care practitioner is also a health-care provider.
(j) “Life-sustaining treatment” includes any medical intervention, including procedures, administration of medication, or use of a medical device, that maintains life by sustaining, restoring, or supplanting a vital function. It does not include care provided for the purpose of keeping a patient comfortable.
(k) “Patient” means the individual who is under the care of the health-care practitioner or health-care provider.
(l) “Patient's authorized representative” or “authorized representative” means the individual signing a DMOST form on behalf of a patient without decision-making capacity, who has the highest priority to act for the patient under law, and who has the authority to make decisions with respect to the patient's health-care preferences being made on the DMOST form such individual is executing on behalf of the patient. The health-care practitioner shall determine the individual who is the patient's authorized representative by referencing the documentation giving such individual the required authority under law. The regulations implementing this chapter shall explain the priority set by law regarding who can act as an authorized representative. Based on the documentation provided by such individual as evidence of his or her authority, the patient's authorized representative could be an individual designated by a patient under an advance health-care directive, an agent under a medical durable power of attorney for health-care decisions, a guardian of the person appointed pursuant to Chapters 39 and 39A of Title 12, in accordance with the authority granted by the appointing court, a surrogate appointed under Chapter 25 of this title, or an individual who is otherwise authorized under applicable law to make the health-care decisions being made by execution of the DMOST form on the patient's behalf, if the patient lacks decision-making capacity.
(m) “Physician” means an individual authorized to practice medicine under subchapter III, Chapter 17 of Title 24.
(n) “Scope of treatment” means those medical interventions, procedures, medications, and treatments that a patient, in consultation with a health-care practitioner, has determined are appropriate, necessary and desired by and for the patient and that a patient has determined to refuse or to allow. Scope of treatment always respects the patient and includes the provision of comfort measures. A patient may decline life-sustaining treatment.
80 Del. Laws, c. 18, §  1;  70 Del. Laws, c. 186, §  1;