Legal Do Not Resuscitate Order Document for New York

How to Use New York Do Not Resuscitate Order

Completing a New York Do Not Resuscitate (DNR) Order form is a significant step in planning for medical care. This form is used to indicate that a person does not wish to have cardiopulmonary resuscitation (CPR) if their heartbeat or breathing stops. It's essential to approach this task with clarity and care, ensuring the wishes of the person are accurately recorded. Below you will find a straightforward guide on how to fill out this form correctly.

1. Begin by obtaining the most current version of the New York DNR Order form. This can usually be found through a healthcare provider or by visiting the New York State Department of Health website.
2. On the top section of the form, fill in the patient's full name, date of birth, and address. This identifies whom the DNR Order applies to.
3. The next section requires the signature of the patient or their health care proxy/agent, if the patient is unable to sign for themselves. This signature is a crucial step, as it signifies the patient's (or their proxy's) understanding and agreement to the DNR order.
4. The date when the form is being signed must also be clearly written next to the signature. This ensures the form is up-to-date.
5. If a health care proxy or agent is signing on behalf of the patient, their relationship to the patient should be noted. This clarifies their authority to make such decisions.
6. A witness, who can be anyone 18 years or older who is not the healthcare proxy, must also sign the form and print their name. This step is necessary to verify the authenticity of the patient or proxy’s signature.
7. Following the patient or proxy section, a physician, nurse practitioner, or physician assistant must complete their part of the form. They will need to include their name, title, and address, and then sign and date their section. This section is crucial as it acknowledges the medical professional's agreement and understanding of the DNR order.
8. The form may also include spaces for additional patient identifiers like hospital or medical record number and patient phone number. Fill these in if applicable.
9. Finally, ensure all parts of the form are filled out correctly and retain a copy for your records. The original should be kept in a place where it can be easily accessed by healthcare providers or family members.

Once the form is fully completed, it serves as a legally binding document indicating that CPR should not be performed in the event of cardiac or respiratory arrest. It’s recommended to discuss having a DNR Order with close family members or caregivers so that they understand your wishes. Additionally, consider informing your doctor or healthcare facility where you receive treatment to include this order in your medical records. Properly completing and storing your DNR Order ensures your healthcare preferences are respected during critical situations.

What is a Do Not Resuscitate (DNR) Order in New York?

A Do Not Resuscitate (DNR) Order in New York is a medical order written by a doctor, which directs healthcare professionals not to perform CPR (cardiopulmonary resuscitation) in the event the patient's breathing stops or the heart stops beating. It is a decision made by the patient or the patient’s healthcare proxy or family, based on the patient's wishes about the type of care they would like to receive at the end of life or if they are unable to communicate their healthcare decisions.

How can someone obtain a DNR Order in New York?

To obtain a DNR Order in New York, a conversation must first take place between the patient and their doctor about the patient's wishes, medical condition, and the benefits and drawbacks of CPR. If a decision is made not to pursue CPR in the event of cardiac or respiratory arrest, the doctor can issue a DNR Order. The order must then be signed by the doctor and, in some cases, by the patient or the patient’s healthcare proxy.

Is a DNR Order permanent?

No, a DNR Order is not permanent. The order can be revoked or canceled at any time by the patient if they are capable of making their own healthcare decisions, or by the healthcare proxy if the patient is not able to make decisions. This revocation must be communicated to the healthcare team. Additionally, the DNR Order should be reviewed regularly, especially if the patient's condition changes.

Who should consider a DNR Order?

A DNR Order should be considered by individuals who are at the end of life or have a terminal illness, and for whom CPR would not offer a meaningful extension of life or could potentially cause harm or reduce the quality of the time they have left. It's also considered by those who wish to die a natural death without invasive life-sustaining measures. Discussing personal values and medical options with healthcare providers and loved ones is an important step in making this decision.

Does a DNR Order affect other treatments?

No, a DNR Order specifically relates to CPR and does not affect other treatments or care that the individual may receive to manage pain, breathing, or other medical needs. Patients with a DNR Order still receive comprehensive medical care; the order merely instructs healthcare providers not to initiate CPR in the event of cardiac or respiratory arrest.

Where should a DNR Order be kept?

For a DNR Order to be effective, it should be easily accessible to healthcare professionals in the event of an emergency. It is advisable to keep the original document in a place where it can be quickly found, such as with personal medical records or on the refrigerator. Copies should also be given to the patient’s healthcare proxy, family members, or caregivers, and the original should be brought during any hospital visit or medical appointment.

Can a DNR Order be used in all healthcare settings?

Yes, a DNR Order is valid in all healthcare settings in New York, including hospitals, nursing homes, and in the home. It is important that healthcare providers are made aware of the DNR Order so they can comply with the patient's wishes. When transferring between different care settings, the DNR Order should accompany the patient to ensure it is respected across all care environments.

What if a patient changes their mind about their DNR Order?

If a patient decides to change their mind about their DNR Order, it is crucial to communicate this decision to their healthcare provider as soon as possible. The patient, or their proxy, should discuss the desired changes, and a new order will need to be completed and signed by the doctor to reflect the updated wishes regarding CPR. Communication with family and all healthcare providers involved in the patient’s care is essential to ensure everyone is informed of the change.

When filling out the New York Do Not Resuscitate (DNR) Order form, it's crucial to complete it correctly to ensure that your wishes are clearly understood and legally recognized. However, several common mistakes can occur during this process:

1. Not verifying the patient's identity properly. It is crucial to ensure that the patient's name, date of birth, and other identifying information are accurately recorded. Mistakes in this area may lead to confusion or misinterpretation of the patient’s wishes.

2. Failing to get the necessary signatures. A DNR order must be signed by both the patient (or their health care proxy) and the physician to be valid. Missing signatures can render the document legally ineffective.

3. Using an outdated form. The state of New York occasionally updates the DNR order form to reflect current laws and regulations. Using an outdated version may result in non-compliance with current legal standards.

4. Omitting the discussion date. The form requires documentation of when the DNR decision was discussed with the patient or their representative. Neglecting to include this date can question the validity of the patient's or surrogate’s understanding and agreement.

5. Incomplete patient or health care proxy section. If a health care proxy is acting on behalf of the patient, their information must be filled out completely. Incompleteness here can lead to questions about the proxy's authority.

6. Not specifying the DNR order's applicability. The form may ask whether the DNR order applies in all settings (hospital, home, etc.) or under specific circumstances. Failure to clarify this can lead to unwanted resuscitation attempts in settings not intended by the patient.

7. Illegible handwriting. If the form is filled out by hand, illegible handwriting can lead to misinterpretation of the patient’s wishes. It is recommended to fill out the form as clearly as possible, or even better, type it if the option is available.

To avoid these mistakes:

• Double-check the patient’s personal information for accuracy.

• Ensure all required signatures are obtained and clearly legible.

• Use the most current version of the DNR form, which can typically be found on the New York State Department of Health website.

• Record the date of discussion with the patient or proxy clearly.

• Complete all sections that apply to the patient or the health care proxy thoroughly.

• Specify when and where the DNR order should be applied without ambiguity.

• Write legibly or, when possible, fill out the form electronically to ensure clarity.

Taking these steps can help ensure that the DNR order accurately reflects the patient’s wishes and is executed accordingly.

In New York, when individuals make decisions about their end-of-life care, a Do Not Resuscitate (DNR) Order is a critical document. However, it's not the only important document used in planning for situations where a person may be unable to make their own healthcare decisions. To ensure that an individual's healthcare wishes are fully respected and followed, several other forms and documents are often used in conjunction with a DNR Order. These documents play pivotal roles in guiding healthcare providers and loved ones through the decision-making process, ensuring that the individual's preferences regarding medical treatment and end-of-life care are clearly understood and implemented.

• Health Care Proxy: This legal document allows an individual to appoint someone they trust (a proxy) to make health care decisions on their behalf if they become unable to do so themselves. The proxy’s authority can cover a wide range of medical decisions, not just those related to life-sustaining treatment.
• Living Will: A Living Will is a written, legal document that details an individual’s preferences regarding medical care if they are unable to communicate these decisions themselves. Unlike a DNR, which is specifically focused on resuscitation, a Living Will provides broader instructions on various life-prolonging treatments.
• Medical Orders for Life-Sustaining Treatment (MOLST): The MOLST form is used by individuals suffering from serious health conditions when they choose to outline specific medical wishes. This includes preferences on the use of ventilators, dialysis, tube feeding, and other life-sustaining treatments in addition to DNR orders. The MOLST is intended for use across healthcare settings.
• Emergency Medical Services (EMS) DNR Order: This form is specifically designed to inform emergency personnel, such as EMTs and paramedics, of an individual’s wish not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. It is an essential document for those who wish to ensure their DNR orders are followed outside of hospital settings.

Together with the DNR Order, these documents form a comprehensive plan that addresses a wide range of circumstances, ensuring that an individual's healthcare preferences are honored in both emergency and non-emergency situations. Healthcare professionals and loved ones are advised to discuss these documents well in advance of medical crises, ensuring they are prepared to uphold the individual's wishes accurately and respect their autonomy and dignity at every stage of care.

The New York Do Not Resuscitate (DNR) Order form shares similarities with an Advance Directive. Both documents allow individuals to express their wishes regarding medical treatment in situations where they may be unable to communicate. An Advance Directive can include a Living Will and a Health Care Proxy, detailing treatment preferences and selecting someone to make decisions on their behalf, much like a DNR specifies wishes not to have CPR in case of cardiac or respiratory arrest.

Similarly, the Medical Orders for Life-Sustaining Treatment (MOLST) form is akin to the DNR order, as it conveys specific instructions about a range of life-sustaining treatments based on the patient’s current health status. Both are used to ensure that the medical care provided aligns with the patient’s wishes, though the MOLST covers a broader array of treatment preferences beyond CPR.

The Physician Orders for Scope of Treatment (POST) form closely resembles the DNR order in purpose and use. POST is designed for patients with serious illnesses and provides instructions for healthcare providers about the patient's preferences for life-sustaining treatments, including resuscitation efforts.

A Health Care Proxy form, while broader in scope, shares commonalities with a DNR by enabling an individual to appoint someone to make healthcare decisions on their behalf. This proxy can make decisions in situations not covered by a DNR, showing a similar respect for the patient's autonomy regarding medical care.

Living Wills, like DNR orders, articulate personal preferences for end-of-life care but are more comprehensive. They encompass a variety of medical decisions, including but not limited to the administration of life-sustaining treatments, whereas DNRs specifically address the issue of resuscitation.

The Five Wishes document, while serving as an Advance Directive, covers personal, emotional, and spiritual needs in addition to medical wishes like a DNR. It provides a broader perspective on end-of-life care, offering a holistic approach to expressing one’s healthcare and personal values.

A Durable Power of Attorney for Health Care document is parallel to a DNR in its empowerment of another individual to make healthcare decisions when the patient is unable to do so. This document can encompass decisions about a wider range of treatments, extending beyond the parameters of a DNR order.

The POLST (Provider Orders for Life-Sustaining Treatment) form, similar to the DNR, is a medically binding document that outlines a patient's preferences for treatments at the end of life, including resuscitation. Both forms are used by those with serious health conditions to ensure that their treatment preferences are followed.

Hospital Release Forms share common ground with DNR orders in that they both involve critical decisions about patient care and precisely communicate the patient's preferences to healthcare providers, although Hospital Release Forms are primarily concerned with the patient's consent to leave the hospital under specific conditions.

Lastly, Emergency Medical Services (EMS) DNR forms, which are similar to the hospital-based DNR orders but are specifically designed for emergency medical technicians and paramedics. These forms indicate the patient’s wish not to undergo CPR in emergency situations outside of the hospital, ensuring that the patient’s end-of-life wishes are honored in the community as well as in medical facilities.

When filling out the New York Do Not Resuscitate (DNR) Order form, it's essential to follow guidelines carefully. Here are things you should and shouldn't do:

• Do ensure the correct version of the form is being used. Forms can be updated, so always use the most current version provided by New York health authorities.
• Do read the form thoroughly before filling it out. Understanding every section is crucial to properly completing the form.
• Do fill out the form with accurate and legible information. It should be clear to anyone who reads it.
• Do discuss the decision with a healthcare provider. This ensures the choices made are well-informed and consider the patient's medical condition.
• Do have the form signed by the required parties. This often includes the patient (or their legal health care proxy) and the attending physician.
• Don't use a pencil or erasable pen when filling out the form. All entries should be made in permanent ink.
• Don't leave sections blank unless instructed to do so. If a section does not apply, indicate with "N/A" (not applicable).
• Don't forget to review and update the form regularly. Any change in the patient's health status or wishes should prompt a review.
• Don't fail to store the form in an easily accessible location. Family members and healthcare providers should know where it is stored in case of an emergency.

There are several misunderstandings about the New York Do Not Resuscitate (DNR) Order form. These misconceptions can lead to confusion about its purpose, implications, and the rights of the patient and their family. Below, we address four common misconceptions to provide clarity:

• Misconception 1: A DNR order means all forms of medical treatment are stopped. This is incorrect. A DNR order specifically directs medical professionals not to perform cardiopulmonary resuscitation (CPR) if a person's heart stops beating or they stop breathing. Other forms of medical treatment, such as pain management, antibiotics, or treatments for conditions other than cardiac or respiratory arrest, can still be provided based on the patient's wishes or the judgment of their healthcare provider.

• Misconception 2: Only a patient can request a DNR order. While it's true that competent adults can request a DNR order for themselves, in cases where a patient is unable to make their own healthcare decisions, a health care proxy, legal guardian, or close family member may be involved in the decision-making process. It's important that these decisions are made considering the known wishes of the patient, including any living wills or advance directives.

• Misconception 3: A DNR order is permanent and cannot be revoked. A DNR order can be revoked at any time by the patient if they are competent to do so, or by the person who originally authorized the DNR order. This allows for flexibility if a patient's condition or preferences change. It's important for patients and families to discuss these wishes and any changes with healthcare providers promptly.

• Misconception 4: DNR orders are only for the elderly or those with terminal conditions. While DNR orders are often associated with end-of-life care, they can be requested by or for anyone regardless of age or health condition. The decision to request a DNR order is based on individual beliefs, values, and medical advice, rather than age or prognosis alone.

The New York Do Not Resuscitate (DNR) Order form is a critical document for those who wish to make clear their preferences about not receiving cardiopulmonary resuscitation (CPR) in the event their heart stops or they stop breathing. Understanding how to properly complete and use this form is important for ensuring that one's healthcare wishes are respected. Here are seven key takeaways to consider:

• Before filling out the form, it is crucial to have a thoughtful conversation with your healthcare provider. Discussing your health status, the implications of a DNR order, and how it aligns with your wishes and values is a vital step.
• The DNR form must be properly completed and signed to be valid. In New York, this means it requires the signature of the patient (or their health care proxy or legal guardian if the patient is unable to sign) and the attending physician.
• A valid DNR order is not just about the initial decision-making process. It should be reviewed periodically, especially if the patient's health condition changes, to ensure that it still reflects the patient's current wishes.
• Communication is key. It is important to inform family members and other loved ones about the existence of the DNR order and where the document is stored to prevent any confusion or misunderstanding during an emergency.
• Carrying a wallet card that indicates you have a DNR order can be lifesaving in situations where you are outside the home and unable to communicate your wishes.
• The DNR order should be accessible. In an emergency, healthcare providers need to be able to verify quickly that a DNR order exists. Therefore, keeping the document in a known and accessible location is essential.
• It is crucial to understand that a DNR order does not mean that you will not receive medical treatment for other conditions. You will still receive appropriate medical care for other medical issues unrelated to the conditions stated in your DNR order.