A DNR is a Do Not Resuscitate Order. It is used to notify medical personnel that should you need cardiopulmonary resuscitation or CPR, you do not wish to be revived and do not want to receive any life sustaining treatment. If you have a terminal illness or chronic disease, are in poor health, or do not want CPR for religious or other reasons, you may want to execute a DNR in addition to your living will or health care directives.If you execute a DNR, you should keep the original where your agent under a health care power of attorney can locate it. You may also want to post a copy of the DNR in a visible place in your home. You can wear medical alert wristbands and other forms of identification to notify health care providers of your DNR order. If emergency medical personnel find you in need of CPR and are not immediately made aware of a DNR Order or do not see you wearing medical alert identification, they will perform CPR.
How to Get a DNR Order
Several organizations and agencies provide information regarding the approved form of DNR Order in each state. To obtain a PreHospital DNR Order, contact your state department of health services or your state medical association. You may also contact your county emergency medical services agency.In addition, execute a durable
health care POA form appointing an authorized agent to make medical decisions on your behalf if you are unable to communicate your wishes.
CPR Directives and Estate Planning
CPR consists of life saving medical procedures used to restart a personís heart or breathing. If your heart has stopped or you have stopped breathing, you may be given CPR. Basic CPR techniques include mouth-to-mouth resuscitation and chest compressions. More advanced CPR techniques include electric shock or electric stimulation, insertion of a tube into the mouth or nose to open the personís airway, open heart chest massage, and injections of medication into the heart.Make sure your estate planning documents, such as your living will and DNR order, provide clear instructions on the type of treatment you want to receive.
PreHospital DNR's vs. InHospital DNR's
The laws regarding Do Not Resuscitate Orders vary from state to state. However, there are generally two types of DNR Orders. The first type is a PreHospital DNR Order which is used when a person is at home or living in assisted living or a nursing home. A PreHospital DNR Order is also sometimes called an Out of Hospital Do Not Resuscitate Order, a Home DNR Order or a CPR Directive. The term used to describe the type of DNR Order that applies in a non-hospital setting under the laws of your state may be different than the terms listed above.
The second type of DNR Order is an InHospital DNR Order, which is used when a person is receiving medical treatment in a hospital. An InHospital DNR Order may require that you sign a particular form or may be issued pursuant to a verbal discussion between you and your doctor. An InHospital DNR Order may also consist of a notation, mark or sticker placed on your medical chart by your physician or another member of hospital staff. If you do not want to receive CPR or other medical procedures to restart your heart or breathing while you are in the hospital, notify the hospital administrator, your physician, or another health care provider at the time of admission.
A Living Will is Not a Substitute for a DNR
If you want emergency medical personnel or your physician to honor your request that you not be given CPR, it is important to have a properly executed DNR Order in place. A living will or advance health care directive is not a substitute for a DNR Order. EMTís and other emergency medical personnel are not trained to interpret lengthy legal documents such as living wills and advance directives. Do not rely on a living will or your agent for health care to carry out your preferences regarding CPR.
The Laws on Assisted Death
For information on physician assisted suicide or euthanasia in the United States, see right to die.
Reasons You May Not Want CPR
1.You are in the advanced stages of a terminal illness, are already suffering, and believe CPR will only prolong your suffering; 2. Medical procedures such as CPR conflict with your religious, cultural or moral beliefs; 3. You are concerned about your health becoming worse or being injured as a result of receiving CPR; or 4. You believe CPR would not benefit your health condition, based on discussions with your doctor or other medical information.