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Back to the Basics – Do Not Resuscitate Orders

Advance Directives

When determining the type of health care you wish to receive in the event that you are no longer able to make medical decisions, advance directives give you the ability to determine when you will continue or cease to receive medical care, the kinds of care or treatment that are acceptable, as well as who has the power to make health care decisions on your behalf as your health care power of attorney/health care proxy. There are a few different types of advance directives, we have previously discussed the health care proxy roles in medical decisionmaking as well as the importance of living wills. Although the names and regulations vary by state law, there are also Medical Orders for Life Sustaining Treatment forms, as well as Do Not Resuscitate Orders that patients can fill out in order to refuse or request medical care.

DNR Orders

If a patient fills out a Do Not Resuscitate Order, they can state whether they would like to refuse resuscitation in the event it is needed, which ensures that their medical wishes will be honored. These situations where resuscitation is needed range from ambulance transportation, to terminal illness and hospice care. DNR Orders allow a patient to request that cardiopulmonary resuscitation (CPR) not be performed if they are to stop breathing. Medical professionals are obligated to attempt to give you CPR if you are not breathing. Once a patient fills out a DNR Order, he or she should deliver it to their doctor in order for it to be included in their medical chart. DNR Orders only pertain to patients who are experiencing cardiac or respiratory arrest, it does not pertain to treatment of injury or surgery.

Out of Hospital DNR Orders

Additionally, the New York State Department of Health has approved a standard Out of Hospital DNR Form that will be recognized as any other DNR form would be. The Out of Hospital DNR Form is meant for patients who are not in a hospital or nursing homes. If an EMT is presented with an Out of Hospital DNR that is signed or a DNR bracelet on the patient, or has made a good faith attempt to identify the patient, the Out of Hospital DNR will be presumed valid. However, if there is any evidence that suggests that the DNR Order revoked, cancelled, or fraudulently created, the patient is conscious and requests resuscitation, there is family conflict regarding the living saving measures, or a doctor states that the order should be disregarded, than the DNR order will not be followed.

 

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