A Do Not Resuscitate (DNR) order instructs health care providers not to perform resuscitation on a patient. Suppose an individual with a DNR suffers a heart attack or stops breathing. In that case, it instructs medical personnel not to try to revive them with CPR, defibrillators, or other life-saving measures. An attorney can draft a DNR order as part of a living will or as a separate document.
CPR is the treatment you receive when your blood flow or breathing ceases. The process may involve:
- Simple efforts such as mouth-to-mouth breathing and pressing on the chest
- Restarting the heart with an electric shock
- Using breathing tubes to open the airways
- Medicines
What Are the Requirements for a DNR Order?
DNR requirements vary from state to state, but generally, a valid order must:
- Signed by the individual or by their legally recognized surrogate health care decision-maker.
- Forbid any health care providers from performing resuscitations.
- Include any other relevant information required by the Probate Code of the appropriate state.
- Contain a physician’s signature (in some states only)
You may not be able to express your wishes regarding CPR due to illness or injury. As a result:
- It may not be possible for your family to override a DNR order that your doctor has already written at your request.
- Someone may have been appointed to speak on your behalf, such as a health care agent. It is possible for this person or a legal guardian to agree to a DNR order on your behalf.
Under certain circumstances, a family member can agree to a DNR order for you if you have not named someone to speak for you. However, this can only occur when you are unable to make your own medical decisions.
Why Have a DNR Order?
Family members who are struggling with emotionally difficult decisions, such as organ donation, can benefit from DNR orders, which clearly indicate the individual’s wishes. DNR orders are added to patients’ medical charts. As a result, the patient’s wishes will be respected.
How to Change a DNR Order
The individual can revoke or change their DNR order at any time without a court order or permission from a doctor.
How Do I Ensure a DNR Order Is Followed?
DNRs are likely to be invoked only if you are incapacitated. Make copies of your order and distribute them beforehand to all people involved with your healthcare choices, such as:
- Your doctor
- Your family
- Close friends
- If applicable, the nursing home where you stay
Additionally, keep a card in your wallet stating that you have a DNR Order as well as an emergency phone number. By doing this, medical professionals will be able to identify your wishes and follow them accordingly.
Do DNR Orders Carry Any Liability?
DNR orders must be followed by health care providers. They may be liable for medical malpractice and breach of duty if they fail to follow your DNR.
The health care provider who follows your DNR order is immune from criminal prosecution, civil liability, professional disciplinary action, administrative sanctions, or any other sanctions. A health care provider must believe, in good faith, that their action was in compliance with the law, and must have been unaware that their decision would violate a patient’s directive.
Can a Surrogate Issue a Do Not Resuscitate Order?
Surrogate health care decision-makers can issue Do Not Resuscitate Orders (DNR) in certain situations for minors or adults who are incompetent or otherwise unable to communicate. DNR requirements vary from state to state. Legal guardians or medical care providers generally have the authority to withhold or withdraw life-sustaining treatment.
Authorized Surrogates: Who Are They?
A state may recognize one or more of the following as authorized surrogates, depending on the patient’s circumstances:
It is also possible for health care providers, such as doctors, to act as surrogate decision-makers in the absence of any of the above surrogates.
When Multiple Surrogates Are Authorized, Who Makes the Decision?
Conflicts may arise if there are multiple surrogate parties. The court can determine the appropriate course of action if the parties cannot agree. Identifying and empowering a single surrogate party in cases of minors or incapacitated adults can help prevent such conflicts by establishing do not resuscitate orders in advance.
How Does a Surrogate Order a DNR?
Courts may use two main standards to determine whether a DNR Order by Surrogate is appropriate:
- Substituted Judgment Standard: The Substituted Judgment standard is primarily used in cases of adults who have been incapacitated and cannot communicate their wishes. To apply this standard, the decision-maker must determine as much as possible what the patient would have likely done
- Best Interests Standard: Generally, the Best Interests standard is used when a surrogate decision-maker must determine the best interests of a minor or infant whose judgment would not likely be used.
What Is a Non-Hospital DNR?
You can sign Non-Hospital DNR orders. A doctor issues this order on a form provided by the State Department of Health.
A patient can give their consent verbally, including over the phone or in writing, with two witnesses. If you have previously signed a living will stating that you do not want extraordinary measures taken on your behalf, this can be considered consent.
You will receive a bracelet showing that the doctor has signed such an order; this will indicate to emergency medical personnel that CPR should not be administered. If you are taken to a hospital, the non-hospital DNR will take effect unless the doctor cancels it for some reason, such as the patient’s request.
Do DNR Orders Last Forever?
A DNR order is not permanent, as a doctor must review it at certain intervals. In the hospital, your DNR order should be reviewed every seven days, but your non-hospital DNR will have to be reviewed at each doctor’s appointment. When you do not see the doctor frequently, you must have the order reviewed at least every 90 days.
You do not need to have the DNR order reviewed more than once every seven days if you are constantly seeing doctors in the hospital. The DNR order will be reviewed every 60 days if you become a permanent resident of a nursing facility.
Should I Incorporate CPR and DNR Instructions Into My Estate Planning?
As a family member, it is important to know what your loved one would prefer regarding CPR and DNR orders so you can make decisions in line with what they would want. Likewise, you should tell your own family members or loved ones what you wish for this kind of treatment. A knowledgeable estate planning attorney can provide you with more information.
Should I Contact a Lawyer?
Suppose you have concerns about surrogate DNR decisions. In that case, it is essential to get an experienced will lawyer to help secure your rights and, if necessary, persuade the court what the right arrangement is for the patient. A DNR is a serious decision that should not be made without the guidance of an attorney. Use LegalMatch to find the right lawyer in your area today.
