For some, one of the most important aspects of their estate plan is a Do Not Resuscitate order, more commonly referred to as a DNR. A DNR tells emergency personnel or hospital staff not to attempt revival in the event that you experience respiratory failure or cardiac arrest. You or your healthcare guardian, as well as your physician, must sign the DNR, and it is important to discuss all that a Do Not Resuscitate order entails with a knowledgeable Pasadena estate planning attorney.
Who Can Create a Do Not Resuscitate Order?
In an ideal world, a DNR is created by the very person that needs it. Typically, the individual has been diagnosed with a fatal condition and they are near the end of their life. Similarly, elderly individuals may wish to have a DNR, and as long as they are not incapacitated and have legal decision making power (they do not have a guardian), either of these two types of people (the very sick or old) can request and fill out a DNR form themselves with no other signature other than their physician’s. Otherwise, one of the following has to happen in order for a DNR to be created:
- Your appointed health care agent can sign the DNR if a Do Not Resuscitate aligns with your known wishes;
- Your physician can sign the DNR without you if you are incapacitated (unable to communicate), are close to death, and you have an advance health care directive or living will that makes your wishes clear that you would want a DNR; or
- Your spouse or closest living relative may sign the DNR if they have legal permission to make healthcare decisions for you.
Those Living in a Nursing Home or Assisted Living Center, or Being Admitted to a Different Hospital
Medical Orders for Life-Sustaining Treatment (MOLST) forms are a necessary aspect of a Do Not Resuscitate order in Maryland for certain individuals, according to the Maryland Attorney General. All newly admitted patients to “assisted living programs, home health agencies, hospices, kidney dialysis centers, and nursing homes” must be offered the opportunity to participate in a MOLST form. Similarly, a MOLST form must be ordered for a patient of a hospital being admitted or discharged to another hospital. A MOLST form, while not an advance health directive, contains “written medical orders related to a patient’s medical condition,” including orders regarding resuscitation and other preferred medical treatments.
Call Maryland Estate Planning Attorney Tara K. Frame Today
According to research published in the National Library of Medicine, many DNRs fail to accomplish the goal of the patient for a variety of reasons. For example, CPR is performed on patients who did not want CPR and had a DNR proving such. Reasons for DNR failures in hospitals include the fact that most DNR discussions occur too late and too infrequently for the patient to fully participate in resuscitation decisions, and the fact that physicians often do not give enough information for patients or surrogates to “make informed decisions and inappropriately extrapolate DNR orders to limit other treatments.”
An experienced Pasadena attorney with Frame & Frame can help you and your family truly understand the process and create the DNR right for you. Don’t hesitate to reach out to our office today for help.
Resources:
marylandattorneygeneral.gov/Health%20Policy%20Documents/HCDAsummary.pdf
ncbi.nlm.nih.gov/pmc/articles/PMC3138592/