How to Obtain a DNR Order Approved for Use in Your State
There are several organizations and agencies that provide information regarding the approved form of DNR Order in each state. To obtain a PreHospital DNR Order, you may contact your state department of health services or your state medical association. You may also contact your county emergency medical services agency. A DNR Order approved for use under your state laws should be available for download on the Internet from one of these agencies or organizations.
The Difference Between a PreHospital DNR Order and an InHospital DRN Order
The laws regarding Do Not Resuscitate Orders vary from state to state. However, there are generally two types of DNR Orders. The first type is a PreHospital DNR Order which is used when a person is at home or living in assisted living or a nursing home. A PreHospital DNR Order is also sometimes called an Out of Hospital Do Not Resuscitate Order, a Home DNR Order or a CPR Directive. The term used to describe the type of DNR Order that applies in a non-hospital setting under the laws of your state may be different than the terms listed above.
The second type of DNR Order is an InHospital DNR Order which is used when a person is receiving medical treatment in a hospital. An InHospital DNR Order may require that you sign a particular form or may be issued pursuant to a verbal discussion between you and your doctor. An InHospital DNR Order may also consist of a notation, mark or sticker placed on your medical chart by your physician or another member of the hospital staff. If you do not want to receive CPR or other medical procedures to restart your heart or breathing while you are in the hospital, notify the hospital administrator, your physician, or another health care provider at the time you are admitted to the hospital.
More Information on Do Not Resuscitate Orders
The following books are suggested reading on DNRs, making the decision to refuse CPR, and related medical decisions in estate planning for end of life care:
The Laws on Assisted Death
For information on physician assisted suicide or euthanasia in the United States, see Right to Die Laws.
The End of Life Advisor offers expert advice on end of life decision making, advance directives, do not resuscitate orders, hospice care, and having conversations with family about your last wishes. Filled with answers to common questions about end of life, this guide also walks you through the steps of planning a funeral and making final arrangements.
What is a Do Not Resuscitate Order or DNR?
A DNR is a Do Not Resuscitate Order. It is used to notify medical personnel that should you need CPR (cardiopulmonary resuscitation), you do not wish to be revived and do not want to receive any life sustaining treatment. If you have a terminal illness or chronic disease, are in poor health, or do not want CPR for religious or other reasons, you may want to execute a DNR in addition to your living will or health care directives.
If you execute a DNR, you should keep the original where your agent for health care can locate it and provide copies to your health care providers, hospital, and family members. You may also want to post a copy of the DNR in a visible place in your home. You can purchase Medic Alert jewelry and other forms of identification from medicalert.org to notify health care providers of your DNR order. If emergency medical personnel find you in need of CPR and are not immediately made aware of a DNR Order or do not see you wearing Medic Alert identification, they will perform CPR.
Reasons You May Not Want to be Given CPR
You are in the advanced stages of a terminal illness, are already suffering, and believe CPR will only prolong your suffering;
Medical procedures such as CPR conflict with your religious, cultural or moral beliefs;
You are concerned about your health becoming worse or being injured as a result of receiving CPR; or
You believe CPR would not benefit your health condition, based on discussions with your doctor or other medical information.
A Living Will is Not a Substitute for a DNR Order
If you want emergency medical personnel or your physician to honor your request that you not be given CPR, it is important to have a properly executed DNR Order in place. A living will or advance health care directive is not a substitute for a DNR Order. EMT’s and other emergency medical personnel are not trained to interpret lengthy legal documents such as living wills and advance health care directives. Do not rely on a living will, a health care directive or your agent for health care to carry out your objectives regarding CPR.
What is CPR?
CPR or cardiopulmonary resuscitation consists of life-saving medical procedures used to restart a person’s heart or breathing. If your heart has stopped or you have stopped breathing, you may be given CPR. Basic CPR techniques include mouth-to-mouth resuscitation and chest compressions. More advanced CPR techniques include electric shock or electric stimulation, insertion of a tube into the mouth or nose to open the person’s airway, open heart chest massage, and injections of medication into the heart.
