Attorney-Approved Do Not Resuscitate Order Form for California

Detailed Steps for Using California Do Not Resuscitate Order

Filling out a Do Not Resuscitate (DNR) Order form in California is a significant step for individuals who wish to make clear their preferences regarding resuscitation attempts in emergencies. This document communicates to healthcare professionals that in the event of cardiac or respiratory arrest, resuscitation should not be attempted. Completing this form correctly ensures that the individual's wishes are respected and legally recognized. The process involves a few specific steps, requiring careful attention to detail to make sure everything is filled out accurately.

1. Start by obtaining the most recent version of the California Do Not Resuscitate Order form from either a healthcare provider or the California Department of Public Health website.
2. Read the entire form carefully to understand the implications of signing a DNR order and ensure it reflects your wishes.
3. Print your full legal name, date of birth, and sex at birth in the designated areas at the top of the form.
4. In the presence of your physician, have a discussion about your decision to ensure it is informed and voluntary. The physician can help clarify any questions you might have about the DNR order.
5. After the discussion, sign and date the form in the designated area to indicate your consent. This action legally documents your wish not to have cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest.
6. Ensure your physician also signs and dates the form. Their signature acknowledges that they have discussed the DNR order with you, and they are in agreement with your decision. The physician's signature is also required for the order to be valid.
7. If applicable, have the form co-signed by a legally authorized representative if the individual is unable to sign it themselves.
8. Ensure a copy of the completed DNR order is kept in an easily accessible location at home, and consider informing close family members or caregivers of the order's existence and location.
9. Carry a wallet identification card that indicates you have a DNR order. Often, you can receive a card from the entity that issued or helped fill out your DNR form.

Completing the California Do Not Resuscitate Order accurately and ensuring that all necessary signatures are in place is crucial for the document to be legally effective. It is recommended to review the order regularly and consider updating it if your health status or wishes change. Remember, this document plays a crucial role in your healthcare planning, ensuring that your wishes are respected during critical moments.

1. What is a California Do Not Resuscitate (DNR) Order?

   A California Do Not Resuscitate (DNR) Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. It is used by individuals who wish to avoid life-sustaining treatments in the event of cardiac or respiratory arrest.

2. Who can request a DNR Order in California?

   In California, any competent adult can request a DNR Order. This includes individuals over the age of 18, emancipated minors, and those legally recognized as competent to make their own medical decisions. Additionally, a legal guardian, healthcare agent, or surrogate decision-maker can request a DNR Order on behalf of someone incapable of making their own medical decisions.

3. How can someone obtain a DNR Order in California?

   To obtain a DNR Order in California, an individual must consult with their healthcare provider. The healthcare provider will discuss the implications of the DNR decision, ensuring that the individual understands their choice. After this discussion, if the individual decides to proceed, the healthcare provider will prepare the DNR Order, which must then be signed by both the patient (or their legal representative) and the healthcare provider.

4. Is a DNR Order the same as a living will?

   No, a DNR Order is not the same as a living will. A DNR Order specifically addresses the use of CPR in emergency situations where the patient has stopped breathing or their heart has stopped. A living will, on the other hand, is a broader document that outlines a person's wishes regarding a range of end-of-life care options, not just resuscitation.

5. Where should a DNR Order be kept?

   A DNR Order should be kept in a place where it can be easily accessed by emergency personnel, such as on the refrigerator, or in a wallet or purse. It is also advisable to inform close family members, caregivers, and possibly even neighbors, of the existence and location of the DNR Order.

6. Can a DNR Order be revoked?

   Yes, a DNR Order can be revoked at any time by the individual who requested it, provided they are still competent to make their own medical decisions. To revoke a DNR Order, the individual should inform their healthcare provider of their decision, and the healthcare provider will update the medical records accordingly. It is also recommended to destroy any physical copies of the revoked DNR Order.

7. What happens if emergency medical personnel are not aware of a DNR Order?

   If emergency medical personnel are not aware of a DNR Order at the time of a medical emergency, they are obligated to perform all necessary life-saving procedures, including CPR. This underscores the importance of ensuring the DNR Order is readily accessible and that family members and caregivers are aware of its existence and location.

8. Can a DNR Order be transferred to other states?

   The validity of a California DNR Order in other states depends on the laws of those states. Some states may honor a California DNR Order, while others may require a new DNR Order to be issued according to their own laws. It is advisable to consult with a healthcare provider or legal counsel when moving to or spending extended periods in another state.

9. Where can one find more information about DNR Orders in California?

   For more information about DNR Orders in California, individuals can consult their healthcare providers or visit the website of the California Department of Public Health. These resources can provide up-to-date information and guidance on how to proceed with a DNR Order.

In California, the Do Not Resuscitate (DNR) Order form is crucial for those who wish to decline CPR (cardiopulmonary resuscitation) in the event that their breathing or heartbeat stops. However, errors can occur during the completion of this form, potentially leading to unwanted medical interventions or confusion in emergency situations. Below are eight common mistakes made when filling out the California DNR Order form:

1. Not consulting with a healthcare provider: Before completing the form, it is important to discuss your wishes and the implications of a DNR order with a healthcare provider to ensure that it aligns with your end-of-life care preferences.

2. Incomplete information: Failing to provide all necessary personal information, such as full legal name or date of birth, can result in the DNR order being considered invalid.

3. Missing signatures: The DNR order must be signed by the individual (or their legally recognized health care decision-maker) and their physician. An unsigned form will not be honored.

4. Not using the correct form: Using an outdated version of the form or a version not recognized by California laws can lead to the DNR order not being respected.

5. Failing to notify family members: Not discussing your DNR order with close family members can lead to confusion and distress during emergency situations.

6. Not making copies accessible: It is crucial to ensure that copies of the DNR order are easily accessible, particularly to emergency medical services, by keeping copies in clear and common locations within the home or with important medical documents.

7. Forgetting to review and update: As personal wishes or health conditions change, the DNR order should be reviewed and, if necessary, updated to reflect current desires regarding CPR.

8. Not understanding the scope: Misunderstanding that the DNR order only pertains to CPR and does not apply to other forms of medical treatment can lead to unexpected outcomes in emergency healthcare situations.

By avoiding these common mistakes, individuals can ensure their healthcare preferences are clearly communicated and respected, providing peace of mind for themselves and their loved ones.

When preparing for medical emergencies or planning end-of-life care, individuals often consider a variety of legal forms and documents in addition to a Do Not Resuscitate (DNR) Order. These documents can help communicate a person's healthcare wishes and ensure they are respected. The California DNR form specifically advises medical personnel not to perform CPR (cardiopulmonary resuscitation) if a person's heart stops or if they stop breathing. Here's a list of other forms and documents that are frequently used alongside a DNR to ensure comprehensive care planning.

• Advance Health Care Directive (AHCD): This document allows you to appoint a healthcare agent to make decisions on your behalf and specify your preferences for medical treatment in situations where you cannot communicate your wishes.
• Physician Orders for Life-Sustaining Treatment (POLST): This form complements a DNR by providing more detailed instructions about other types of life-sustaining treatments you want or do not want, such as feeding tubes or antibiotics.
• Medical Power of Attorney (MPA): Similar to an AHCD, an MPA designates a person to make healthcare decisions for you if you're unable to do so, but it might not include specific instructions about the types of treatments you wish to receive or avoid.
• Living Will: A living will is a written document that details your wishes regarding medical treatment if you become incapacitated and cannot communicate. It often addresses situations that are not covered by a DNR, such as long-term care in case of severe brain damage or terminal illness.
• Organ and Tissue Donation Registration Form: This form allows you to register your decision to donate your organs and tissues after death. It can be included in your medical records or carried with you on a driver’s license or ID.
• Financial Power of Attorney: This document appoints someone to manage your financial affairs if you are unable to do so yourself, ensuring that your bills, investments, and property management continue smoothly without court intervention.
• Will: A will is a legal document that spells out how you want your property and assets to be distributed after your death. While not directly related to health care, it is often part of comprehensive end-of-life planning.
• Privacy Release Form (HIPAA Authorization): This form allows designated individuals to access your medical records, making it easier for your healthcare agent or family members to make informed decisions about your care.
• Portable Medical Order File or Card: While not a document, having a portable medical order file or card that contains or summarizes all of these documents can be invaluable in an emergency. It ensures that your healthcare preferences are clearly communicated to anyone providing medical treatment.

Each of these documents plays a crucial role in healthcare planning, working together to ensure that an individual's medical and personal wishes are honored. Having these forms properly completed and accessible can provide peace of mind to both the individual and their loved ones. It's important to discuss these documents with healthcare providers, legal advisors, and family members to ensure they are accurately prepared and reflect the person's current wishes.

• Living Will: This document, similar to a Do Not Resuscitate Order (DNR), enables individuals to outline their wishes for medical treatment and care in the event that they become unable to communicate those wishes themselves. Both documents are designed to guide healthcare professionals and loved ones in making medical decisions that align with the individual's preferences, especially concerning end-of-life care.

• Healthcare Power of Attorney: This designation allows an individual to appoint someone else to make healthcare decisions on their behalf if they become incapable of making those decisions themselves. While it covers a broader set of decisions beyond the scope of a DNR, which is specific to not performing cardiopulmonary resuscitation, both documents serve to ensure that healthcare choices are made according to the patient's wishes when they can't speak for themselves.

• Advance Directive: An advance directive is an umbrella term that can include a living will, a DNR order, and other healthcare directives. It is specifically designed to detail a person’s healthcare preferences, including the refusal or acceptance of life-sustaining treatments, in advance. The similarity lies in their foundational goal: to respect and uphold an individual's healthcare preferences when they cannot actively communicate them.

• Medical Orders for Life-Sustaining Treatment (MOLST): Similar to a DNR, MOLST forms detail what types of life-sustaining treatment a patient wishes to receive or avoid. The MOLST is more comprehensive, often covering options like intubation, antibiotic use, and feeding tubes, beyond the scope of cardiac resuscitation covered by a DNR.

• Physician Orders for Life-Sustaining Treatment (POLST): Functionally similar to a MOLST, a POLST form also guides medical personnel regarding a patient's preferences for life-sustaining treatments. Both POLST and DNR orders are legally binding and directly inform healthcare providers of a patient’s end-of-life wishes, including but not limited to CPR preferences.

• Do Not Intubate (DNI) Order: A DNI order is specifically designed to prevent the use of intubation for a patient who cannot breathe on their own or is in respiratory distress. While a DNR focuses on the absence of CPR efforts, both DNR and DNI orders address critical aspects of a patient's desire for limited medical intervention under specific circumstances.

• Five Wishes Document: The Five Wishes document is a type of advance directive that addresses personal, spiritual, medical, and legal wishes at the end of life. While it encompasses more than a DNR by including elements such as the patient's wish for comfort and how they want people to treat them, it similarly aims to ensure that medical care aligns with the patient's values and desires.

• Emergency Medical Services (EMS) DNR Order: An EMS DNR is specifically designed to prevent emergency medical technicians or first responders from performing CPR in the event of cardiac arrest outside of a hospital setting. Similar to a standard DNR, the EMS DNR is crucial for patients seeking to avoid specific life-extending interventions during emergency situations.

Filling out the California Do Not Resuscitate (DNR) Order form is a crucial step for individuals wishing to make their end-of-life care wishes known. Here are essential dos and don'ts to consider during this process:

• Ensure readability. Write legibly or type the information to prevent misunderstandings during critical moments.

• Confirm accuracy. Double-check all details, especially personal information like your full name, date of birth, and address, to ensure they match your official documents.

• Get proper signatures. The form must be signed by the person it concerns or their legally recognized healthcare decision-maker, as well as the attending physician, to be valid.

• Discuss with your healthcare provider. Before completing the form, have a conversation with your doctor about your health status and care preferences to make informed decisions.

• Keep it accessible. Once completed and signed, ensure the DNR order is kept in a place where it can be easily found by family members or emergency responders, like on the refrigerator or with other important medical documents.

• Inform your family and caregivers. Let those close to you know about your DNR order and where it is stored, so they are prepared to advocate on your behalf.

• Delay discussions. It's important not to wait until a medical crisis occurs to complete a DNR order. Planning ahead allows for thoughtful decision-making without pressure.

• Fill it out alone. Involve your healthcare provider and loved ones in the discussion to ensure your wishes are understood and can be honored.

• Forget to update. If your health situation or wishes change, it is crucial to update your DNR order accordingly to reflect your current preferences.

• Use unofficial forms. Always use the California-approved DNR form to ensure it meets state legal requirements and is recognized by healthcare professionals.

• Overlook legal requirements. Each state has its own laws regarding DNR orders. Make sure your form complies with California's specific statutes to ensure it's legally valid.

• Assume one size fits all. Every individual's health status and end-of-life wishes are unique. Be clear about your specific desires regarding resuscitation and other interventions.

Many people have misconceptions about the California Do Not Resuscitate (DNR) Order form, which can lead to confusion about its use and implications. By clarifying these misconceptions, individuals can make more informed decisions regarding their medical care and end-of-life wishes. Here are four common misunderstandings about the DNR Order in California.

• A DNR Order is the same as a Living Will: People often confuse these two documents. While both pertain to directives for medical care, they serve different purposes. A DNR Order specifically instructs healthcare providers not to perform CPR if your breathing stops or if your heart stops beating. A Living Will, on the other hand, outlines a broader range of end-of-life care preferences, including treatments you do and do not want.

• Having a DNR means you’ll receive no medical treatment: This is a common fear, but it’s not accurate. A DNR Order applies only to CPR. It doesn’t affect other types of medical interventions you may need or want. For example, if you have an infection, you can still receive antibiotics, or if you’re in pain, you can receive medication to alleviate that pain.

• Only elderly or terminally ill patients can have a DNR Order: While it’s true that DNR Orders are more common among these groups, anyone can choose to have a DNR Order. The decision is based on personal beliefs, values, and discussions with family and healthcare providers, regardless of age or health status.

• A DNR Order is difficult to revoke: Some believe that once a DNR Order is in place, it cannot be changed. This is not true. If you have a change of heart or your medical condition changes, you can update or revoke your DNR Order at any time. It’s important to communicate any changes in your desires with your healthcare team and family.

When dealing with the California Do Not Resuscitate (DNR) Order form, it's important to be well-informed about its purpose, how to fill it out correctly, and what it means for the individual it concerns. Below are eight key takeaways to help guide individuals through this process:

• The California DNR Order is a legal document used to inform medical personnel that a person does not want to be resuscitated in the event their heart stops or if they stop breathing. This is crucial for ensuring that an individual's wishes regarding end-of-life care are respected.
• To be valid, the form must be completed and signed by a licensed California physician. The physician’s signature signifies that they have discussed the DNR order with the patient (or their legal decision-maker) and agree that it is the appropriate decision based on the patient's current health condition and wishes.
• The individual for whom the DNR order is issued must be clearly identified on the form. This includes their full name, date of birth, and any other identifying information required by the form to ensure there are no mistakes in identification during a critical moment.
• It's essential for the individual or their decision-maker to discuss all questions and concerns with a healthcare provider before completing the DNR form. This discussion should cover the implications of a DNR order and how it affects the medical care an individual will receive in emergency situations.
• A DNR order does not mean that the individual will be denied other forms of medical intervention. Treatment for pain, discomfort, and other conditions can still be provided, aiming to ensure the patient's comfort.
• Once completed and signed, the DNR form should be kept in a location where it can be easily found by family members and emergency personnel. Many choose to place it on the refrigerator or in another prominent location in the home. Additionally, carrying a copy of the DNR order or wearing a DNR bracelet can also inform healthcare providers of the individual's wishes.
• It's advised to review the DNR order periodically, especially if there's a significant change in the individual's health condition. Reevaluation with a healthcare provider ensures that the DNR order still reflects the person's current wishes and medical needs.
• Legally, the DNR order is only applicable in California. If the individual travels or moves to another state, they should consult with healthcare providers or legal counsel in that state about how to ensure their wishes regarding resuscitation are respected.

Understanding and carefully considering a Do Not Resuscitate Order is a crucial step for individuals and their families when planning end-of-life care. It provides a clear directive to healthcare professionals, ensuring that the individual’s wishes are followed in critical moments.