Who Determines a Do Not Resuscitate Order in Virginia?

A do not resuscitate order, or DNR, is a medical order instructing medical providers on how to proceed when a patient’s heart or breathing stops. Anyone can sign a do not resuscitate order if they are not incapacitated and they have the mental capacity to make this type of medical decision. If you sign a DNR order, it means you do not want your healthcare team to take any life-saving measures to keep you alive, such as performing CPR. A DNR is most relevant for older adults near the end of their lives or people with a terminal illness.

Signing a DNR Order

You can request to sign a do not resuscitate order if you are not incapacitated and do not have a current appointed guardian to make medical decisions on your behalf. Only you and your doctor will need to sign the form for it to become valid and enforceable.

However, other individuals can determine that a DNR order is necessary under these circumstances:

• A healthcare agent you appointed can sign a DNR order if it meets your wishes regarding end-of-life care.
• A spouse or relative can sign the order if they have the legal authority to make your medical decisions.
• A doctor can sign a DNR without your signature if you become incapacitated, close to the end of your life, and have a valid living will making your wishes known about life-saving measures.

Common Reasons for a DNR Order

A do not resuscitate order might seem extreme. It may be difficult to understand someone’s reasoning for rejecting life-saving measures.

However, resuscitation efforts could result in new medical problems in addition to the ones the patient already has. The most common reasons someone might choose to sign a DNR order include:

• CPR is less likely to work on people who are older and suffering from a severe illness.
• Often, some people experience new medical issues if CPR is successful. For example, chest compressions can break someone’s ribs, leading to additional medical complications and extreme pain.
• Brain damage can occur when a person’s heart stops. After CPR brings them back, they could experience challenges, such as speaking, walking, and caring for themselves.

Communicate with Your Loved Ones

Your family might disagree with your decision to sign a do not resuscitate order. It is important to share your wishes and reasoning about how you want to spend your final days. Talk to your family about your feelings regarding extraordinary measures. It is crucial to communicate your wishes clearly with your family and loved ones.

If you decide to sign a DNR there are a few steps you can take to make sure your wishes are followed:

• Keep the order with your estate planning documents and keep them on hand and display the DNR where emergency personnel might find you in an emergency.
• Give copies to all of your medical team members.
• When traveling, have a copy with you and provide a copy to your traveling companions.
• Look into medical jewelry or alerts designed for persons with a DNR.

As a reminder, a DNR addresses life saving measures such as CPR but does not address other treatments such as pain medication or nutrition, so it is important to have other legal documents such as a Healthcare Power of Attorney and a Living Will in addition to your Will or Trust with your DNR.

While creating an estate plan, you should consider whether you want to sign a DNR order. Speak with an experienced lawyer to discuss your options and decide which one is best for you. Having this decision in place before a time of need will ensure your wishes are protected and met. If you have any additional questions about how to document your end-of-life wishes, contact us at (757) 645-3176 or (866) 603-5976 to schedule an appointment at one of our offices located in Williamsburg, Newport News, Virginia Beach or McLean.