A Do Not Resuscitate (DNR) order is a medical instruction that tells health care providers not to perform CPR if your heart stops or if you stop breathing. This includes refusing artificial ventilation, endotracheal intubation, and cardioversion (heart-stimulating drugs or electric shocks).
While many people associate a DNR with a hospital, it can also be part of your estate plan. Creating your DNR is a deeply personal decision, but it’s vital to include it with your other important health care directives. This helps prevent confusion in crisis moments, reduce stress for your family, and conduct your wishes exactly as you intend.
The requirements for creating a DNR vary from state to state. In California, a DNR order must include your name and the order date and be signed by you or your healthcare agent and your physician. Let’s take a look at what else you need to consider.
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Instructions for your agent
When you include a DNR in your estate plan, you need to provide clear instructions for your health care proxy or agent. Some directives require specific questions to be answered, such as whether you want life-sustaining treatment or medically administered nutrition and hydration.
Other states use broader language, allowing your agent more latitude to decide end-of-life decisions based on your instructions. This often includes the intention to remove you from life support if you have a terminal illness or injury and your death is imminent.
In addition to DNR orders, some states have adopted MOLST forms (Medical Orders for Life-Sustaining Treatment) as a complement to advanced health care directives. California, however, uses POLST forms (Physician Orders for Life-Sustaining Treatment). Both types of forms provide instructions for emergency medical services in and out of hospitals and address critical care like intubation, mechanical ventilation, and dialysis.
A POLST typically includes:
- The types of life-sustaining treatments you want or refuse (e.g., CPR, intubation, or ventilation).
- Preferences for medical interventions (i.e., full treatment, limited treatment, or comfort care).
- Decisions about artificial nutrition and hydration.
- Your signature (or representative’s) and your physician’s signature.
Printed on bright pink paper, POLSTs give patients with a serious illness control over how their end-of-life wishes are honored. At a time when life feels unpredictable, this empowers you to have honest, difficult conversations with your loved ones and providers. It also gives your agent the guidance to act with confidence and carry out your wishes exactly as you intended.
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Yes, you can change your mind
You might have heard that DNR orders are difficult to revoke. A DNR decision is not permanent and you can change your mind at any time, either verbally or in writing. Even if you’re in an emergency, you can tell an EMT or healthcare provider to disregard your existing order. And if you decide to modify your estate plan, you can revoke or change it later to reflect your most up to date health care directives.
Not sure if you need a DNR? Attorney Rodney Hatley can help you review your options, explain how a DNR works in California, and guide you during this difficult decision. Contact us today for a free confidential consultation!
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