A Do Not Resuscitate (DNR) order can complement a living will and a health care power of attorney in expressing an individual’s preferences regarding end-of-life care. Essentially, this order provides that someone does not want to receive cardiopulmonary resuscitation (CPR) from emergency medical personnel if it otherwise would be appropriate. If you do not have a DNR order, you will receive CPR automatically as part of emergency efforts to save your life.
These documents also may be known as DNR forms, DNR directives, or Comfort Ones, and they can be used in hospitals or other contexts. While virtually any adult can craft a DNR order, they are especially relevant for people who have philosophical objections to receiving CPR, are suffering from a terminal illness, or have a serious heart or respiratory condition. The existence of a DNR order may be shown by wearing a visible indicator like a bracelet, necklace, or ankle bracelet.
Putting a DNR Order in Effect
Withholding CPR means that you will not receive chest compressions, electric shock treatments to your chest, artificial ventilation, tubes in your airways to assist breathing, or drugs to stimulate your heart. You may want to consult with one or more doctors to find out more about the pros and cons of withholding CPR. Most likely, you will need a doctor to sign a DNR order for it to be valid, and sometimes a doctor will need to complete the paperwork for you. Otherwise, your state health department may be able to assist you.
You also may want to discuss your decision to establish a DNR order with your family members and other caregivers. If you put the order into effect, whether or not you wear a visible indicator, you should make sure that the form is easily available. You probably will receive CPR if your form cannot be found, if it appears to have been altered, or if its legitimacy is at all uncertain.
A form called a Physician Order for Life Sustaining Treatment (POLST) may be used to complement or replace a DNR order. It also may be known as a Clinician Order for Life Sustaining Treatment (COLST) or a Medical Order for Scope of Treatment (MOST). It covers not only CPR but also other life-sustaining measures, including the use of antibiotics, feeding tubes, and intubation. However, it should not be viewed as a replacement for an advance health care directive.
Like DNR orders, POLST forms must be signed by a doctor or another health care professional. The form is often printed on bright paper to make it obvious in an individual’s medical records so that emergency medical personnel or other health care providers can find it more quickly.