Attorney-Approved Do Not Resuscitate Order Template

Do Not Resuscitate Order - Usage Guidelines

Understanding the gravity of a Do Not Resuscitate (DNR) order is essential before initiating the process. This legal document plays a pivotal role by instructing healthcare providers not to perform cardiopulmonary resuscitation (CPR) in the event a patient stops breathing or their heart ceases beating. Filling out this form accurately is vital as it directly impacts the type of medical care one will receive during critical moments. Following the right steps ensures that your healthcare preferences are clearly documented and will be honored.

To properly complete a Do Not Resuscitate Order form, please adhere to the following guidelines:

1. Start by collecting all necessary personal information, including your full legal name, date of birth, and current address. This information ensures that the form is linked correctly to your medical records.
2. Provide a detailed medical diagnosis if required. Some forms request a description of the medical condition that justifies the request for a DNR order. This information assists healthcare providers in understanding the context of the decision.
3. If the form requires it, include the name and contact details of your healthcare proxy or legal agent. This is the individual authorized to make medical decisions on your behalf, should you become unable to do so.
4. Review any specific instructions or conditions under which the DNR order should be applied. Some individuals may want the order to be effective only under certain circumstances. Clearly specify these preferences.
5. Sign and date the form. This is a crucial step as it validates that the request is made voluntarily and with a clear understanding of its implications. In many instances, witness signatures may also be required to further authenticate the document.
6. Lastly, consult with a healthcare provider to ensure the DNR order is properly entered into your medical records. They may also need to sign the form, depending on state requirements.

Completing a Do Not Resuscitate Order form is an act of asserting control over one's healthcare outcomes. Once filled out, it is imperative to inform family members, healthcare proxies, and primary care physicians of its existence and location. Advance planning ensures that your wishes are respected, providing peace of mind to you and your loved ones.

What is a Do Not Resuscitate Order (DNR)?

A Do Not Resuscitate Order (DNR) is a legal document that tells healthcare providers not to perform CPR (cardiopulmonary resuscitation) if a person's heart stops or if they stop breathing. This order is used for people who are near the end of life or have a condition where CPR would not be effective or desired.

Who can request a DNR Order?

Adults who are mentally competent can request a DNR Order for themselves. For children or adults unable to make their own medical decisions due to a disability or condition, a legal guardian or someone with medical power of attorney can request a DNR on their behalf.

How can one obtain a DNR Order?

To obtain a DNR Order, one must speak to a healthcare provider. The healthcare provider will discuss the individual's health condition, the implications of a DNR Order, and what it means for emergency healthcare. If the individual decides to proceed, the healthcare provider will prepare the documentation that must be signed by the patient (or their designated representative) and the healthcare provider.

Is a DNR Order permanent?

No, a DNR Order is not permanent. The individual who has requested the DNR Order, or their legal guardian or representative, can cancel or revise the order at any time. This is a critical feature of patient rights, allowing individuals to change their end-of-life care preferences as their situation or wishes evolve.

Does a DNR Order affect other treatments?

No, a DNR Order specifically addresses CPR and does not impact other treatments or care. For example, a person with a DNR Order can still receive antibiotics, pain relief, nutrition, hydration, and other forms of care that can improve quality of life or comfort.

How is a DNR Order different from a living will?

A DNR Order is different from a living will. A DNR Order is a specific instruction not to perform CPR. In contrast, a living will is a broader document that can outline various medical treatments an individual wishes to receive or avoid at the end of life. While a DNR focuses on CPR, a living will can encompass a wide range of medical interventions.

When considering the completion of a Do Not Resuscitate (DNR) Order form, individuals are faced with a sensitive and highly personal decision. This document is pivotal in conveying one's wishes regarding the extent of medical interventions to be taken in the event that their heart or breathing stops. However, during this process, several common errors can occur. Recognizing and avoiding these mistakes ensures that an individual's medical treatment preferences are clearly understood and respected.

1. Not consulting with a healthcare provider: Before filling out a DNR order, it is crucial to discuss one's health condition and treatment preferences with a healthcare provider. This discussion provides valuable insights into the implications of a DNR order based on one's specific health situation.

2. Failing to fully understand the form: Sometimes, individuals do not take the time to fully comprehend the significance and consequences of each section of the DNR order. This lack of understanding can lead to choices that may not accurately reflect their wishes.

3. Missing signatures: A DNR order typically requires the signatures of the individual and their healthcare provider to be valid. Overlooking these signatures can render the document legally ineffective.

4. Not specifying circumstances: If the form allows, failing to specify under what health conditions the DNR should apply can lead to confusion. Clarifying whether the DNR is applicable under all circumstances or only certain conditions is essential.

5. Not updating the form: Health preferences can change over time. Not updating a DNR order to reflect current wishes can result in treatment that is not in line with the individual's latest preferences.

6. Improper storage: Keeping the DNR order where it is not easily accessible, such as a safe deposit box, can delay its discovery and implementation in critical moments.

7. Lack of copies: Failing to distribute copies of the DNR order to relevant parties, such as family members, healthcare proxies, and doctors, can prevent the document from being honored in a timely fashion.

8. Not discussing the decision with family: Neglecting to discuss one's decision to have a DNR order with family members can lead to confusion and distress during emergency situations. Open communication ensures that everyone understands and respects the decision.

In summary, the process of completing a DNR order is a serious undertaking that requires thoughtful consideration and thorough discussion with healthcare providers and loved ones. By avoiding these common mistakes, individuals can take a meaningful step toward ensuring their healthcare preferences are honored during critical moments.

When someone decides to have a Do Not Resuscitate (DNR) order, it is often part of a broader end-of-life care plan. This plan might include several other forms and documents designed to ensure their medical and personal wishes are respected. These documents play a crucial role in communicating an individual's preferences to family members and healthcare providers, particularly in situations where the person can't make their wishes known. The following are some of the forms and documents that are commonly used alongside a DNR order.

• Advance Directive: This document allows individuals to outline their preferences for medical treatment and care in situations where they are unable to communicate their decisions. It can also designate a health care proxy to make decisions on their behalf.
• Living Will: Often used in tandem with an advance directive, a living will specifically addresses the types of life-sustaining treatments an individual wishes to accept or refuse, such as mechanical ventilation, feeding tubes, and resuscitation efforts beyond a DNR order.
• Medical Power of Attorney (Health Care Proxy): This legal document appoints someone to make health care decisions for the individual if they are incapacitated. The appointed person, known as a health care proxy, is usually trusted to make decisions that align with the individual's preferences as outlined in their advance directive or living will.
• POLST Form (Physician Orders for Life-Sustaining Treatment): This medical order is signed by both a patient and their physician and outlines a plan of care for those who are seriously ill or at the end of life. A POLST form can include the patient's DNR order and preferences regarding other life-sustaining treatments.

Together, these forms provide a comprehensive framework for end-of-life planning. They ensure an individual's health care preferences are known and respected, offering peace of mind to both the person and their family. Having these documents in place, especially along with a DNR order, facilitates clear communication with healthcare providers and avoids unnecessary or unwanted medical interventions in critical moments.

• Living Will: Similar to a Do Not Resuscitate (DNR) Order, a Living Will provides instructions regarding medical care a person wishes or does not wish to receive in the event they become unable to communicate their decisions. It may include directions on the use of life-sustaining treatments.

• Healthcare Power of Attorney: This document designates an individual to make medical decisions on behalf of someone else, should they become unable to do so. While it encompasses broader decision-making authority, it can specify preferences about treatments like resuscitation.

• Advance Directive: An Advance Directive is a broader term that can include both a Living Will and a Healthcare Power of Attorney. It outlines a person’s wishes regarding medical treatment and appoints an agent to make decisions, similar to the purpose a DNR serves in preventing unwanted medical interventions.

• Physician Orders for Life-Sustaining Treatment (POLST): POLST goes beyond a traditional DNR by providing more detailed instructions regarding a range of life-sustaining treatments, based on the patient's current health status.

• Medical Orders for Scope of Treatment (MOST): Similar to POLST, a MOST form is a doctor's order that delineates a patient’s preferences for life-sustaining treatments, including resuscitation, in more detail.

• Five Wishes Document: This is a type of Advance Directive that addresses personal, spiritual, and medical wishes at the end of life. It includes preferences on resuscitation, thus sharing aims with a DNR Order.

• Hospital Discharge Planning Documents: These documents plan for a patient’s care after leaving the hospital and can include directives about the types of medical interventions the patient wants or does not want, incorporating principles similar to those found in a DNR.

• Out-of-Hospital DNR Order: Specifically intended for emergencies that occur outside the hospital, this document directs emergency medical personnel not to perform CPR, similar to a standard DNR but applicable in any non-hospital setting.

• Durable Power of Attorney for Healthcare Decisions: This legal paper allows an individual to make healthcare decisions on someone’s behalf, potentially including decisions about resuscitation, highlighting the common theme of directing one’s medical care.

• Emergency Medical Services (EMS) Protocol Documents: These are guidelines followed by EMS personnel, potentially including protocols for DNR orders, ensuring emergency responders respect the patient’s wishes regarding resuscitation and other emergency treatments.

Understanding and completing the Do Not Resuscitate (DNR) Order form accurately is crucial. This document is important for ensuring that a person's wishes regarding life-saving procedures are respected. Here are key dos and don'ts that one should follow:

Things You Should Do

1. Ensure that the person for whom the DNR order is intended fully understands the implications of the document.
2. Have the document signed by the required medical professional, as stipulated by state laws, to validate the order.
3. Fill out the form with clear and precise information to avoid any confusion during emergency situations.
4. Keep multiple copies of the completed DNR order in easily accessible locations.
5. Inform family members and healthcare providers of the existence and location of the DNR order.

Things You Shouldn't Do

• Avoid leaving blank spaces that could lead to misinterpretations or delays in emergency care.
• Do not use ambiguous language that might confuse healthcare professionals about the patient's wishes.
• Refrain from storing the DNR order in a place where it can't be found easily by family members or emergency responders.
• Never complete the form without the full agreement of the person it concerns, unless they are legally unable to make their own decisions and you are authorized to do so on their behalf.
• Do not forget to review and update the DNR order periodically to ensure it reflects current wishes and legal requirements.

Do Not Resuscitate (DNR) orders are widely misunderstood, leading to confusion and distress among patients and their families. Clarifying these misconceptions is vital to ensure that the choices surrounding end-of-life care are well-informed and respect the patient's wishes. Here are six common misconceptions about DNR orders:

• Myth 1: DNR means no treatment at all. A DNR order specifically refers to not performing cardiopulmonary resuscitation (CPR) if a patient's breathing or heartbeat stops. It does not mean withholding other forms of care, such as pain management, oxygen, or antibiotics, which can all be continued according to the patient's wishes or as deemed appropriate by their care team.

• Myth 2: Only elderly individuals can have a DNR order. Age is not a criterion for a DNR order. It can be appropriate for patients of any age who, due to a chronic and severe medical condition, would not benefit from CPR or would consider it not in line with their goals for quality of life.

• Myth 3: A DNR order must be initiated by the patient. While ideally, a DNR order is made after a discussion with the patient regarding their wishes, there are circumstances where family members or healthcare proxies may be involved in making this decision, especially if the patient is unable to communicate their desires due to their medical condition.

• Myth 4: DNR orders are irreversible. A DNR order can be revoked or modified at any time by the patient if their condition changes or they change their mind about what interventions they want at the end of life. Such adjustments should be communicated clearly to the healthcare team.

• Myth 5: If you have a DNR, doctors won't work as hard to save you. This belief is entirely unfounded. Healthcare providers are committed to offering the best care possible within the scope of the patient's wishes. A DNR order affects only the use of CPR and does not influence other therapeutic efforts to treat injuries or illnesses.

• Myth 6: A DNR order is only for the terminally ill. While it's common among those with terminal illnesses, a DNR order may also be considered by individuals with chronic conditions, severe disabilities, or those who simply want to ensure a natural death without aggressive life-prolonging interventions. The choice for a DNR order is deeply personal and varies significantly among individuals.

When it comes to healthcare, particularly during critical moments, understanding the purpose and implications of a Do Not Resuscitate (DNR) Order is essential. Here are six key takeaways that can help individuals make informed decisions regarding DNR Orders:

• Definition and Purpose: A DNR Order is a medical document, signed by a physician, that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) in the event a patient's heart stops or they stop breathing. Its primary purpose is to respect the patient's wishes regarding end-of-life care.
• Individual Autonomy: Filling out a DNR Order is a deeply personal decision, enabling an individual to have control over their own health care decisions and ensuring that their wishes are known and respected in critical situations.
• Medical Requirements: To put a DNR Order into effect, it requires not only the patient's consent (or that of a legally authorized representative if the patient is incapable) but also a physician's assessment that the patient fully understands the implications of such an order. The physician must sign the DNR Order, making it a legally binding document.
• Location of DNR Orders: DNR Orders can be applied both in hospital settings and at home. Ensuring that the DNR Order is readily available and can be quickly presented to emergency personnel or healthcare providers is crucial.
• Revocation Process: It is important to know that a DNR Order is not permanent and can be revoked by the patient or their legal representative at any time. This allows for flexibility should the patient's circumstances or wishes change.
• Legal and Ethical Considerations: Each state has its own laws and regulations regarding DNR Orders, including how they are documented and when they take effect. It is advisable to become familiar with the specific regulations in one's state and consider ethical implications, including how this decision aligns with personal values and beliefs.

In conclusion, a DNR Order is a significant medical directive with profound implications. It is pivotal to approach this decision with careful thought, clear understanding, and thorough discussion with healthcare professionals and loved ones. Remember, the ultimate goal of a DNR Order is to ensure that a patient's medical care aligns with their wishes, especially in moments when they may not be able to communicate those wishes themselves.