Attorney-Verified Do Not Resuscitate Order Template for Pennsylvania

Guide to Filling Out Pennsylvania Do Not Resuscitate Order

When a person decides that they do not wish to have resuscitation attempts made in the event of a cardiac or respiratory arrest, a Pennsylvania Do Not Resuscitate (DNR) Order form is used to document this preference. Completing this form is an important step for those who wish to ensure their healthcare preferences are respected during critical moments. The process requires careful attention to detail, as accuracy is paramount in conveying one’s wishes to medical personnel. Below are the step-by-step instructions to accurately fill out the Pennsylvania Do Not Resuscitate Order form.

1. Begin by accurately printing the patient’s full name at the top of the form. This ensures the form is associated with the correct individual.
2. Enter the patient's date of birth, providing clarity on the patient’s identity.
3. Include the patient's home address to further confirm the identity and residence of the individual issuing the DNR order.
4. Specify the patient’s county of residence. This information may affect local protocol or the jurisdiction of health orders.
5. If applicable, note the name and contact information of the patient's legal guardian or power of attorney. This is crucial if the patient is not capable of making their own medical decisions.
6. In the section designated for the attending physician, the physician must print their name. This identifies who has approved and is overseeing the DNR order.
7. The physician must then include their medical license number. This verifies the physician's authority to issue a DNR order.
8. Fill in the date the DNR order is issued. This indicates when the order becomes active.
9. The patient (or the patient’s legal guardian/power of attorney if the patient is unable) must sign the form, demonstrating their agreement and understanding of the DNR order’s implications.
10. The attending physician's signature is also required, signifying their concurrence with the patient's wishes and confirming that the appropriate discussions have taken place.
11. Finally, include any relevant comments or additional instructions in the space provided. This may cover specific conditions or circumstances under which the DNR order should or should not be applied.

Following these steps carefully ensures that the Pennsylvania Do Not Resuscitate Order form is filled out correctly and completely, allowing healthcare professionals to respect and follow the patient's wishes in critical situations. It is advisable to discuss this form and its implications thoroughly with a healthcare provider to ensure it aligns with the patient’s health care preferences and goals.

What is a Do Not Resuscitate Order in Pennsylvania?

A Do Not Resuscitate (DNR) order in Pennsylvania is a medical directive made by a patient or their authorized representative that instructs health care providers not to perform cardiopulmonary resuscitation (CPR) if the patient's breathing stops or if the patient's heart stops beating.

Who can request a DNR order in Pennsylvania?

In Pennsylvania, a DNR order can be requested by any adult with the capacity to make healthcare decisions for themselves or by a legal guardian, health care agent, or surrogate for a patient who lacks decision-making capacity. The patient must consent to the DNR order if they are able.

How do you get a DNR order in Pennsylvania?

To get a DNR order in Pennsylvania, the patient or their authorized representative must discuss the patient’s wishes with a healthcare provider. The healthcare provider, often a physician, will then complete and sign the Pennsylvania DNR order form.

Is there a specific form for a DNR order in Pennsylvania?

Yes, Pennsylvania has a specific form that must be completed by a healthcare provider to put a DNR order into effect. This form documents the patient's or authorized representative's consent and the physician's order.

Can a DNR order be revoked or changed?

Yes, a DNR order can be revoked or changed at any time by the patient if they are capable of making their own healthcare decisions, or by their authorized representative. Revoking or changing a DNR order typically involves notifying the healthcare provider verbally or in writing.

What happens if emergency personnel are called?

If emergency personnel, such as paramedics or emergency medical technicians, are called, they must follow the DNR order if it is presented to them or if they are otherwise made aware of it. It is important for the DNR order to be easily accessible in an emergency.

Does a DNR order affect other treatments?

No, a DNR order only applies to cardiopulmonary resuscitation (CPR). It does not affect any other medical treatments or interventions a patient might receive to treat pain, injury, or illness. Patients with a DNR order still receive all other appropriate medical care.

Is a DNR order valid in settings outside of a hospital?

Yes, in Pennsylvania, a DNR order is valid in any setting, including at home, in a hospital, or in other healthcare facilities. It is important for the DNR order to be communicated to and recognized by healthcare providers in any setting where the patient receives care.

How does a DNR order work with an advanced directive?

A DNR order can be part of an advanced directive in Pennsylvania, which may also include other instructions regarding a person's healthcare preferences in case they become unable to communicate their wishes. While an advanced directive can provide broad instructions about many types of healthcare decisions, a DNR order specifically addresses the issue of CPR.

What should you do with a completed DNR order form?

Once a DNR order form is completed and signed in Pennsylvania, it should be kept in a place where it can be quickly and easily accessed by family members or caregivers. Copies should also be provided to applicable healthcare providers, and it may be beneficial to keep a copy with personal identification if emergency care is sought outside of the home.

When it comes to filling out the Pennsylvania Do Not Resuscitate (DNR) Order form, attention to detail is paramount. Any omission or error can potentially lead to misunderstandings about the individual's end-of-life wishes. Here are eight common mistakes people often make while completing this crucial document.

1. Not consulting with a healthcare provider: Before completing the DNR form, it's essential to have a conversation with a healthcare provider. This step ensures that the individual fully understands the medical implications of a DNR order.

2. Failing to use the patient's legal name: Using a nickname or omitting a middle name can create confusion. It's critical to use the legal name as it appears on official identification.

3. Overlooking the need for witness signatures: The Pennsylvania DNR form requires the signatures of witnesses. Neglecting to have the form witnessed can invalidate the document.

4. Ignoring the expiration date: Some individuals are not aware that DNR orders can expire. It’s important to review and renew the order as necessary.

5. Misunderstanding the scope of the DNR: Some people mistakenly believe that a DNR order refuses all treatments. It's vital to understand that it only applies to cardiopulmonary resuscitation, not other medical interventions.

6. Forgetting to distribute copies of the form: After completing and signing the DNR form, copies should be given to relevant parties, such as family members, doctors, and hospitals.

7. Neglecting to review and update the form: Life circumstances and health preferences can change. Regularly reviewing and updating the DNR order ensures that it reflects current wishes.

8. Omitting to discuss the decision with loved ones: Ensuring that family members are aware of and understand the decision can prevent conflicts or confusion in stressful times.

Completing a DNR form is a significant step in end-of-life planning. It communicates an individual's wishes regarding resuscitation efforts in situations where they cannot speak for themselves. By avoiding these common mistakes, individuals can ensure that their healthcare preferences are clearly understood and respected.

When preparing for end-of-life care or medical emergency situations, individuals often consider a Pennsylvania Do Not Resuscitate (DNR) Order alongside other important documents. A DNR order instructs healthcare providers not to perform CPR if a patient's breathing stops or if the heart stops beating. While a DNR is critical for those wishing to avoid certain life-extending procedures, it's part of a broader ensemble of legal documents designed to ensure a person's healthcare wishes are respected and financial matters are in order. Understanding these documents can empower individuals and their loved ones to make informed decisions about their care and affairs.

• Advanced Healthcare Directive (Living Will): This document lets individuals specify their preferences for medical care if they become unable to make decisions for themselves. It covers a range of treatments and can include decisions about life support, organ donation, and pain management.
• Medical Power of Attorney: A Medical Power of Attorney designates someone to make healthcare decisions on behalf of the individual if they are incapacitated. This person, often called a healthcare proxy, can ensure that healthcare providers follow the individual's wishes as outlined in their advanced healthcare directive.
• Financial Power of Attorney: This allows someone to manage the financial affairs of the individual if they cannot do so themselves. The scope can be broad or limited, covering tasks such as paying bills, managing investments, or selling property.
• Living Trust: A Living Trust is a legal arrangement where one's assets are placed into a trust for their benefit during their lifetime, and then transferred to designated beneficiaries when they pass away. It can help avoid the often lengthy and costly probacy process.
• POLST Form (Physician Orders for Life-Sustaining Treatment): While similar to a DNR, a POLST form provides more comprehensive instructions regarding end-of-life care preferences, such as the use of antibiotics, artificial nutrition, and hydration.

Each of these documents plays a vital role in comprehensive end-of-life planning. They ensure that an individual's healthcare and financial wishes are known and respected, providing peace of mind to them and their families. It's important for anyone considering a DNR to also explore these accompanying documents, consulting with healthcare and legal professionals to create a plan that best reflects their wishes and needs.

The Pennsylvania Do Not Resuscitate Order form is similar to several other legal documents that also deal with medical and end-of-life decisions. These include the Advance Healthcare Directive (Living Will) and the Medical Power of Attorney. Although these documents serve similar purposes, they have distinct roles in a person’s healthcare planning.

The first document that bears resemblance to the Pennsylvania Do Not Resuscitate (DNR) Order form is the Advance Healthcare Directive, often referred to as a Living Will. Like a DNR, a Living Will allows an individual to outline their wishes regarding the medical care they wish to receive or refuse, especially concerning life-sustaining treatment. However, while a DNR specifically addresses the use of CPR (cardiopulmonary resuscitation) in emergency situations, an Advance Healthcare Directive encompasses a wider range of medical interventions and treatments an individual may or may not want in various medical scenarios, including but not limited to end-of-life care.

The second document closely related to a DNR is the Medical Power of Attorney (also known as a Healthcare Proxy). This legal instrument allows an individual to designate another person to make healthcare decisions on their behalf should they become unable to do so. Similar to a DNR, it's a proactive measure, ensuring that someone's healthcare preferences are honored. However, the key difference is in the scope; while a DNR focuses solely on the act of resuscitation, a Medical Power of Attorney covers all medical decisions, giving the appointed proxy the authority to interpret and implement the individual's healthcare wishes across any situation that might arise.

The Pennsylvania Do Not Resuscitate (DNR) Order form is a critical document for those who wish to have their choices respected regarding resuscitation efforts in an emergency. Filling out this form correctly ensures your wishes are legally documented. Here are essential dos and don'ts to consider when completing your DNR Order form:

• Ensure all information is accurate and legible. Misunderstandings or errors can lead to unwanted outcomes.
• Discuss your decision with your healthcare provider. They can provide valuable insights and ensure your decisions are based on accurate medical information.
• Include your full legal name and date of birth to avoid any confusion with similar patient records.
• Sign and date the form in the presence of the required witnesses. Pennsylvania law may require these witnesses for your DNR order to be considered valid.
• Inform family members or other close contacts about your DNR order. Understanding your wishes can help avoid conflict or confusion in stressful situations.
• Keep the original copy of your DNR order in a safe but accessible place. Copies should be readily available to present to healthcare professionals when needed.
• Review and update your DNR order as necessary, especially if your health condition changes.

• Leave any sections of the form blank. Unfilled sections can lead to questions about your intentions and potentially delay urgent decisions.
• Use abbreviations or nicknames. This can lead to confusion or misidentification in critical situations.
• Forget to provide a copy of your DNR order to your primary healthcare provider. They should be aware of your wishes and able to include this information in your medical records.
• Fail to communicate your wishes to your health care proxy or durable power of attorney for health care, if you have one. They need to be fully informed to advocate effectively on your behalf.
• Overlook the need for witnesses or notarization, if required by Pennsylvania law. This oversight could invalidate your DNR order.
• Assume healthcare workers outside of Pennsylvania will honor your DNR order. Laws and regulations can vary greatly by state.
• Delay completing a DNR form if you are certain about your wishes. The absence of a DNR order can result in the automatic initiation of CPR and other resuscitation efforts you may not want.

When talking about Do Not Resuscitate (DNR) orders, especially within Pennsylvania, several misconceptions can cloud the understanding of what these orders entail. Let’s clarify some of these common misunderstandings.

• A DNR order applies to all medical treatments. This is incorrect. A DNR order specifically relates to CPR (cardiopulmonary resuscitation) in the event a person’s breathing or heart stops. It does not apply to other types of medical interventions or treatments.
• Only the elderly or terminally ill can have a DNR order. This isn’t true. While DNR orders are often associated with the elderly or those with terminal conditions, they can be requested by anyone for a variety of reasons related to their personal beliefs or medical condition preferences.
• Doctors can override a DNR order if they disagree. Doctors are bound to respect a legally completed DNR order. They cannot override it based on personal beliefs or preferences. However, in certain emergency circumstances, if there is uncertainty about the order, life-saving measures might temporarily be initiated until clarification is obtained.
• A DNR order is permanent and cannot be changed. Actually, a DNR can be revoked or changed at any time by the person it concerns, provided they are competent to make such decisions, or by their legally designated healthcare proxy or power of attorney.
• Having a DNR means you won’t get admitted to the hospital. This is a misconception. A DNR order only affects the use of CPR; it does not mean that you cannot receive other medical treatments, be admitted to a hospital, or receive palliative care.
• Family members can initiate a DNR order for a relative. While family members can discuss and even advocate for the wishes of their relative, a DNR order must be completed by a competent individual or their designated healthcare proxy or power of attorney. It is a personal medical decision that should ideally reflect the individual’s wishes.
• All healthcare facilities honor DNR orders. Most do, but some may have policies that affect how DNR orders are implemented, particularly in emergency situations or in certain healthcare settings. It’s essential to check with healthcare providers to ensure that a DNR order will be respected across different care settings.
• A DNR order is effective immediately once signed. While essentially true, for a DNR order to be considered valid, it often needs to be reviewed and cosigned by a physician or other authorized healthcare provider. Without this, the order might not be recognized during a medical emergency.

It’s important for individuals and their loved ones to thoroughly understand the specifics of DNR orders, especially within their respective state guidelines, to make informed decisions regarding end-of-life care preferences. Pennsylvania, like any state, has its own rules and procedures that govern the execution and recognition of these orders, making it crucial to consult with a healthcare provider or a legal professional to navigate these choices effectively.

When considering a Do Not Resuscitate (DNR) Order in Pennsylvania, it's crucial to approach the matter with both sensitivity and informed judgment. Below are essential takeaways regarding the completion and use of the Pennsylvania DNR Order form:

• Understanding the Purpose: A DNR Order is designed to inform medical professionals not to perform cardiopulmonary resuscitation (CPR) in the event an individual's breathing or heartbeat stops.
• Eligibility: To be eligible for a DNR Order, a person must be diagnosed with a terminal condition where the healthcare provider believes CPR would not be successful or the individual has expressed a wish to avoid aggressive life-sustaining treatments.
• Legal Requirements: The Pennsylvania DNR Order requires specific information to be valid, including the individual's name, date of birth, and the signature of a licensed healthcare provider.
• Importance of Healthcare Provider's Role: A healthcare provider must thoroughly discuss the implications of a DNR Order with the individual (or their decision-maker) to ensure they fully understand the meaning and consequences.
• Voluntary Process: Opting for a DNR Order is entirely voluntary. One should never feel coerced into making this decision.
• Revocation: An individual can revoke their DNR Order at any time. This revocation must be communicated clearly to the healthcare provider.
• Accessibility of the Order: Once completed, the DNR Order should be kept in an easily accessible location. In an emergency, healthcare providers should be able to find it promptly.
• Inclusion in Medical Records: The DNR Order must be included in the individual's medical records. It's advisable to inform all healthcare providers involved in the person's care about the order.
• Recognition Across Settings: Pennsylvania's DNR Order is recognized in various settings, including hospitals, nursing homes, and by emergency medical services, ensuring that the individual's wishes are respected throughout the healthcare system.
• Periodic Review: It's recommended to review the DNR Order periodically, especially if the individual's health status changes. Any updates or reaffirmations of the order should be discussed with a healthcare provider.

Approaching the topic of a DNR Order is a deeply personal decision that involves careful consideration and discussion with loved ones and healthcare providers. It's a vital step in ensuring that the individual's wishes are honored in their healthcare journey.