A Do-Not-Resuscitate order, commonly referred to as a “DNR,” is a legally binding directive to all of a patient’s health care providers. Although considered one of several Advance Health Care Directives, this document is usually not part of your estate plan.
As noted by its title, it instructs caregivers to abstain from providing life support measures to a patient in the event that the patient stops breathing or his heart stops beating. Specifically, it orders caregivers not to provide conventional CPR, defibrillation, heart massage, or any other techniques that may be deemed invasive in order to revive the patient.
DNR at the Hospital or at Home
A DNR can be initiated with your consent by your primary or attending physician when you are admitted to a hospital, nursing home, or hospice facility, if he feels you are suffering from a terminal illness and recovery is unlikely. The DNR is then included in your chart so that the facility’s staff will be aware of your wish not to be resuscitated should your heart or lungs cease functioning.
An Out-of-Hospital DNR can also be initiated for a patient receiving end of life care at home. The patient is usually provided with a bracelet so that Emergency Medical Service (EMS) first responders (police, fire or emergency medical technicians staffing an ambulance service (paid or volunteer)) are aware of the person’s wishes not to be resuscitated.
A DNR Order is a serious legal document and if knowingly ignored by a medical provider there are both professional and legal consequences for violating a patient’s rights.
Competency to Establish a DNR
Obviously a competent person suffering from a terminal illness can set up a DNR. However, what if someone is not considered mentally competent?
In this situation a surrogate can set up the Do-Not-Resuscitate Order. Ideally, such a surrogate or health care agent is designated by a Health Care Proxy, sometimes called a “medical power of attorney.” The surrogate can be a family member, attorney, court appointed guardian, or any individual deemed responsible to make health care decisions on a patient’s behalf.
If you have not appointed someone to speak for you, a family member could agree to set up a DNR order on your behalf. However, this could create problems in a family if all the members do not agree.
Having a Plan in Place
As you can see, a DNR is an important document to have if the circumstances are appropriate. You can get it set up upon admission to a hospital, or similar facility, or while receiving end of life care at home.
Regardless of whether you need a DNR or not, the most important point is to have a plan in place before an emergency strikes. At a minimum, you need the appropriate Advance Health Care Directives (living will and health care power of attorney with a HIPPA release) in place.
If you have any questions on the DNR, Advance Health Care Directives, or anything else related to estate planning, please do not hesitate to contact AJC Law Office at 201-664-0540 or www.schedulefreeconsult.com.