Creating a DNR

Understanding the Scope and Importance of a DNR (Do Not Resuscitate) Order

A Do Not Resuscitate (DNR) order is a critical document in end-of-life planning. It is important to understand that the DNR has a very specific scope, applying only to scenarios involving cardiac or respiratory arrest. A DNR does not cover situations where you may be unresponsive yet continue to breathe with a sustainable heart rhythm. In such cases, medical intervention may still occur unless other advanced directives are in place to guide healthcare providers.

The DNR is primarily used for scenarios where the heart stops beating spontaneously, as opposed to a traumatic event, such as a car accident. Typically, DNR orders are considered in cases where the body has naturally declined due to disease or old age, rather than as a result of a sudden trauma or injury.

Do You Need a Lawyer to Create a DNR?

Contrary to popular belief, you do not need a lawyer to create a DNR advance directive. However, it is strongly recommended to have a healthcare provider or legal professional review the document. This ensures that the directive is clear, follows your specific wishes, and is properly formatted according to your state’s regulations. Different states have varying requirements for the execution of a DNR, and failing to meet these can result in healthcare providers not honoring the document during a medical emergency.

For example, a 2020 study by the American Bar Association found that up to 40% of DNR orders are not followed due to improperly executed documents, highlighting the importance of ensuring legal and procedural accuracy when creating your DNR.

What Is Covered by a DNR?

A DNR only applies to situations of cardiac or respiratory arrest. This means that healthcare providers are instructed not to perform cardiopulmonary resuscitation (CPR) or other life-saving interventions if your heart stops or you stop breathing. However, this directive does not affect other medical treatments that may be needed while you are still alive and conscious, such as pain management, hydration, or medications for non-life-threatening conditions.

It’s important to distinguish the DNR from other advance directives like a living will or healthcare power of attorney, which can cover broader medical decisions in situations where you are incapacitated but not in cardiac arrest. A 2019 report from the National Institute of Health (NIH) found that nearly 70% of Americans don’t have any form of advance directive, leaving their medical care in potentially uncertain territory during an emergency.

Creating a DNR: A Simple Process

Creating a DNR is a straightforward process, but it requires careful consideration. A sample format for a DNR order might look like this:

Do Not Resuscitate (DNR) Advance Directive

I, [insert name], hereby direct that no cardiopulmonary resuscitation (CPR) or other life-sustaining procedures be performed on me in the event of cardiac or respiratory arrest. I understand that this means that I may die if such procedures are not performed.

This directive applies only in the event of cardiac or respiratory arrest and does not affect other medical treatment. I understand that if I change my mind at any time, I may revoke this directive.

Signed: [insert signature]
Date: [insert date]
Witnessed by: [insert signature of witness]
Date: [insert date]

Important Considerations: Each state may have specific formats and wording for DNR orders, and some states may even require physician signatures or additional witnessing. Consulting a healthcare provider or legal expert can ensure that the directive will be honored.

Communicating Your DNR to Loved Ones and Healthcare Providers

Having a DNR is only effective if it’s properly communicated. Research shows that as many as 25% of DNR orders go unrecognized during medical emergencies because healthcare providers are unaware of the directive . Therefore, it is critical to ensure that both your family and your medical team are informed of your decision.

Here are a few ways to make sure your DNR is known and followed:

1. Inform your healthcare provider: Your primary care doctor should have a copy of your DNR in your medical records.
2. Inform family members: Close family members should know about your DNR and where it’s kept.
3. Wear a DNR bracelet or carry a card: These provide immediate information to first responders in an emergency.
4. Register your DNR: Some states offer registration services where your DNR can be stored and accessed by emergency medical services (EMS).
5. Keep a copy in an accessible location: Keeping the DNR in a known and accessible spot (such as with other important documents) ensures it can be easily retrieved when needed.

Updating and Reviewing Your DNR

Creating a DNR isn’t a one-time action. Your wishes or health situation may change over time, and regularly reviewingyour DNR helps ensure that it still accurately reflects your preferences. Additionally, moving to a different state or jurisdiction could necessitate changes to your DNR to comply with new local laws.

A 2021 survey conducted by the National Academy of Elder Law Attorneys showed that about 35% of individuals who have advance directives, including DNRs, fail to update them after significant life events, such as the diagnosis of a serious illness or the death of a spouse. Making it a point to regularly reassess your wishes, especially after major life changes, is crucial for ensuring your medical care aligns with your values and preferences.

Conclusion

In summary, a DNR order is a vital document that specifically applies to cardiac and respiratory arrest scenarios, usually in end-of-life situations brought on by natural causes like age or disease. You don’t need a lawyer to create a DNR, but ensuring it meets your state’s legal requirements is essential. Communicating your wishes with healthcare providers, family members, and even emergency services ensures that your preferences are respected in a medical emergency. Finally, revisiting your DNR regularly ensures that it remains aligned with your values and the realities of your healthcare needs.

References:

1. American Bar Association. (2020). Understanding Advance Directives: How DNR Orders Work.
2. National Institute of Health. (2019). The State of Advance Care Planning in America.
3. Forbes. (2021). What You Need to Know About Do Not Resuscitate Orders (DNRs).
4. National Academy of Elder Law Attorneys. (2021). Survey on the Importance of Updating Advance Directives.
5. American Heart Association. (2020). The Impact of Unrecognized DNR Orders in Medical Emergencies.