Do Not Resuscitate (DNR) Order

Written by True Tamplin, BSc, CEPF®

Reviewed by Subject Matter Experts

Updated on September 01, 2023

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What Is a Do Not Resuscitate (DNR) Order?

A Do Not Resuscitate (DNR) Order is a legal document that instructs healthcare providers not to perform Cardiopulmonary Resuscitation (CPR) in the event of a cardiac or respiratory arrest.

A DNR order can be included as part of an individual's advance directive or living will, which outlines their wishes for medical treatment in the event they become unable to make decisions for themselves.

By including a DNR order in their estate planning documents, individuals can ensure that their end-of-life care aligns with their personal beliefs and values. It also helps to relieve their loved ones from the burden of making difficult medical decisions in a time of crisis.

Legal Aspects of DNR Orders

State-Specific Laws and Regulations

Each state has its own regulations and requirements for creating and implementing DNR orders. It is essential to familiarize oneself with these guidelines to ensure that a DNR order is legally binding and properly executed.

Required Documentation for DNR Orders

DNR orders are typically documented using specific forms mandated by each state. These forms must be completed and signed by both the patient and a licensed healthcare provider, such as a physician, nurse practitioner, or physician assistant. In some cases, witnesses may also be required.

Legal Implications for Healthcare Providers

Healthcare providers must abide by DNR orders, as they are legally bound to respect patients' end-of-life preferences. Failure to comply with DNR orders can result in legal consequences, including potential malpractice lawsuits.

Communicating DNR Preferences

Tips for Communicating Do Not Resuscitate (DNR) Preferences

Discussing DNR Orders With Family Members and Loved Ones

It is important to have open and honest conversations with family members and loved ones about end-of-life preferences and the reasons behind choosing a DNR order. This discussion can help prevent misunderstandings and disputes in the future.

Appointing a Healthcare Proxy or Power of Attorney

A healthcare proxy, also known as a durable power of attorney for healthcare, is a legal document that designates a trusted individual to make medical decisions on behalf of the patient in case they become incapacitated.

The designated proxy should be aware of the patient's DNR preferences and be willing to advocate for them.

Informing Healthcare Providers About DNR Preferences

Patients should inform their healthcare providers, including primary care physicians and specialists, about their DNR preferences to ensure that their wishes are known and respected.

Integrating DNR Orders Into Estate Planning Documents

Advance Directives

Living Wills

A living will is a legal document that outlines an individual's preferences for medical treatment, including end-of-life care. DNR orders can be incorporated into living wills to provide clear instructions to healthcare providers.

Durable Power of Attorney for Healthcare

As mentioned earlier, a durable power of attorney for healthcare designates a trusted individual to make medical decisions on behalf of the patient. It is essential to include DNR preferences in this document to ensure that the designated proxy is aware of and can advocate for the patient's wishes.

Including DNR Orders in Wills and Trusts

While less common, some individuals may choose to include DNR orders in their wills or trusts. This approach can provide an additional layer of documentation and ensure that the patient's end-of-life preferences are respected.

Updating Estate Planning Documents to Reflect DNR Preferences

It is essential to update estate planning documents periodically to ensure that they accurately reflect current DNR preferences. Changes in health status, personal beliefs, or family dynamics may necessitate revising these documents.

Ethical Considerations Surrounding DNR Orders

Balancing Personal Autonomy and Medical Ethics

DNR orders allow individuals to exercise their autonomy in making end-of-life decisions. However, healthcare providers must balance respecting patient autonomy with their professional obligations to provide appropriate medical care.

Addressing Cultural and Religious Beliefs

Cultural and religious beliefs can significantly impact end-of-life decisions, including DNR orders. It is essential to consider and respect these beliefs while discussing and implementing DNR preferences.

Healthcare providers and families should work together to ensure that the patient's wishes align with their cultural and religious values.

Navigating Difficult Family Dynamics

In some cases, family members may have differing opinions about DNR orders and end-of-life care. Open communication and mediation can help resolve these conflicts and ensure that the patient's wishes are respected.

Managing Disputes and Potential Challenges

Resolving Conflicts Among Family Members

When conflicts arise among family members regarding DNR orders, it is crucial to focus on the patient's wishes and preferences. Mediation or counseling may be helpful in resolving disputes and finding a mutually acceptable solution.

Dealing With Healthcare Providers Who May Disagree With DNR Orders

Healthcare providers must respect DNR orders even if they personally disagree with the patient's decision. If a healthcare provider is unwilling to comply with a DNR order, the patient or their healthcare proxy may need to seek a different provider who will honor the patient's preferences.

Legal Remedies for Upholding DNR Preferences

If a healthcare provider fails to comply with a legally binding DNR order, the patient or their loved ones may pursue legal action to enforce the patient's end-of-life preferences.

Reevaluating and Updating DNR Orders

Periodic Review of DNR Preferences

Individuals should regularly review their DNR preferences to ensure that they still align with their values and medical conditions. Changes in health status or personal beliefs may warrant updating DNR orders.

Modifying DNR Orders in Response to Changing Health Conditions

If a patient's health condition changes, they may need to modify their DNR order to reflect their current circumstances. This may include revising the scope of the DNR order or revoking it entirely.

Communicating Updates to Relevant Parties

When DNR preferences change, it is crucial to communicate these updates to healthcare providers, family members, and the designated healthcare proxy to ensure that everyone is aware of the patient's current wishes.

The Bottom Line

DNR order is an essential aspect of ensuring that end-of-life wishes are respected and followed.

By understanding the legal, ethical, and practical considerations surrounding DNR orders, individuals can make informed decisions about their end-of-life care and communicate their preferences to healthcare providers and loved ones.

Regularly reviewing and updating DNR orders can help ensure that these important decisions remain aligned with the patient's values and medical needs.

Do Not Resuscitate (DNR) Order FAQs

About the Author

True Tamplin, BSc, CEPF®

True Tamplin is a published author, public speaker, CEO of UpDigital, and founder of Finance Strategists.

True is a Certified Educator in Personal Finance (CEPF®), author of The Handy Financial Ratios Guide, a member of the Society for Advancing Business Editing and Writing, contributes to his financial education site, Finance Strategists, and has spoken to various financial communities such as the CFA Institute, as well as university students like his Alma mater, Biola University, where he received a bachelor of science in business and data analytics.

To learn more about True, visit his personal website or view his author profiles on Amazon, Nasdaq and Forbes.

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