Estate Planning Isn’t Just For The Elderly

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Is A Do Not Resuscitate Order (DNR) Appropriate For You?

Over the last decade, our attorneys have had many clients request the preparation of a Do Not Resuscitate Order (DNR) for their signature. However, contrary to the understanding of most clients, a DNR is a medical order entered into the patient’s medical record that requires the consent and signature of a physician as well as the patient. Under New York DNR law, any adult patient can request a Do Not Resuscitate order.

Generally, a DNR is executed when an individual has a history of chronic disease or terminal illness, such as chronic lung disease or heart disease, that has in the past or may in the future necessitate cardiopulmonary resuscitation (CPR), and the patient no longer wishes to be revived because of concerns that the use of CPR may not be successful and may result in the patient being brain damaged or impaired.

If a DNR is in the patient’s medical chart, the medical staff is instructed not to try to revive a patient if breathing or heartbeat has stopped. Thus, physicians, nurses and others are not to initiate emergency procedures such as chest compression, mouth-to-mouth resuscitation, electroshock, insertion of tube to open airways and other forms of resuscitation. If the patient is a resident of a nursing home, the DNR instructs the staff not to perform resuscitation.

Physicians Are Not Obligated To Approve A DNR Request

It should be noted that merely because you (or any patient) request a DNR order from your physician, that said doctor is not bound to enter the order in your chart if they do not believe it is appropriate. If the physician does not believe it should be entered on your chart, the physician must transfer your care to another physician or refer the matter to dispute mediation in the hospital or nursing home.

When And How A Loved One Can Request A DNR For The Patient

If a patient is unable to consent to a DNR order because he or she lacks capacity (is unable to decide for himself or herself), a family member or friend can consent under one of the following conditions:

(a) The patient has a terminal condition.
(b) The patient is permanently unconscious.
(c) CPR would be medically futile.
(d) CPR would impose an extraordinary burden given the patient’s medical condition and the expected outcome of CPR.

The person deciding on the patient’s behalf must know the wishes of the patient. For this reason, the patient’s designated health care proxy may be the most appropriate party to make such a request.

If a DNR order has been entered on a patient’s chart and the patient decides that he or she no longer wishes to have it, it can be withdrawn.

Seek Clarity On These Documents With The Help Of An Attorney

While a DNR serves as a valuable instrument for those with severe chronic and terminal illnesses, its effective implementation, especially in a nonnursing home or hospital setting, has been difficult, particularly when emergency medical services (EMS) are contacted because someone has stopped breathing. Even when a DNR order has been presented when EMS arrives, issues and disputes have arisen as to the administration of emergency CPR procedures.

The bottom line is that DNRs are complex legal tools, and it is important to understand their proper uses and limitations. While an estate planning attorney cannot create a DNR for you, they can answer your questions and provide guidance on planning for late-life medical emergencies.

Contact Us Today To Discuss Your Elder Law Needs And Options

From our office in White Plains, Enea, Scanlan & Sirignano, LLP, serves clients in Westchester County, throughout the Hudson Valley and Downstate New York. If you’re ready to plan your estate, update an existing plan or learn more about your options, we invite you to schedule an initial consultation with one of our skilled and attentive attorneys. To get started, call us at 914-269-2367 or submit an online contact form.

Enea, Scanlan & Sirignano, LLP