Blank Do Not Resuscitate Order Form for New York

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

A Do Not Resuscitate Order (DNR) in New York is a medical order that tells health care providers not to perform cardiopulmonary resuscitation (CPR) if a person's breathing stops or if the heart stops beating. It is intended for patients with serious illnesses or those at the end of life who choose not to have CPR conducted.

How can someone get a DNR order in New York?

To get a DNR order in New York, a patient must discuss their wishes with their doctor. The doctor must then agree that a DNR order is in the patient's best interest based on their medical condition and overall health goals. Once agreed upon, the doctor will fill out the DNR form, which must be signed by both the doctor and the patient, or the patient’s health care proxy or legal guardian if the patient is unable to sign.

Where does a DNR order apply?

In New York, a DNR order applies in various settings, including hospitals, nursing homes, at home, and in other non-hospital settings. The order should be visible to healthcare providers, such as being placed on the refrigerator or in a visible location in the patient's room, when implemented at home.

What is the difference between a DNR and a living will?

A DNR is a specific order not to use CPR if a patient's heart stops or they stop breathing. A living will, on the other hand, is a broader document that can include a person's preferences on a variety of end-of-life treatments, including conditions under which they would not want to be kept alive with artificial life support, but it does not automatically include a DNR order.

Can a DNR order be revoked or changed?

Yes, a DNR order can be revoked or changed at any time. The patient or their designated health care proxy can request to revoke or change the DNR order through a discussion with the patient's doctor. Following this, the necessary documentation will be updated to reflect the patient's new wishes.

What should one do if they change their mind about their DNR order?

If someone changes their mind about their DNR order, they should communicate their new wishes as soon as possible to their doctor or health care proxy. The medical team can then take steps to update or revoke the DNR order according to the patient’s current preferences.

Does having a DNR order mean you will not receive any medical treatment?

No, having a DNR order does not mean a person will be denied other medical treatments. The DNR order specifically instructs healthcare providers not to perform CPR. Patients with a DNR order will still receive all other appropriate medical treatments and interventions based on their condition and preferences.

Who should consider a DNR order?

Individuals with serious, life-limiting illnesses, those who are at the end of life, or those with specific wishes not to receive CPR in the event of cardiac or respiratory arrest should consider a DNR order. It is important to have open discussions with family, health care proxies, and medical providers when considering a DNR order.

Filling out the New York Do Not Resuscitate (DNR) Order form requires attention to detail and a clear understanding of the process. Mistakes can lead to misunderstandings or an order that doesn't reflect the individual's true healthcare wishes. Here are nine common errors:

1. Not verifying the patient's identity accurately - It's crucial to ensure that the patient's personal information, such as full name, date of birth, and address, matches their official documents to avoid any confusion.

2. Skipping the requirement for witness signatures - The form mandates witness signatures to validate the authenticity of the DNR request. Neglecting this step can render the DNR invalid.

3. Lack of clear communication between the patient and healthcare provider about what a DNR order entails often leads to misconceptions and a misrepresentation of the patient's wishes.

4. Failing to include a physician's signature - For a DNR order to be legally binding, it must be signed by a licensed physician. Overlooking this step means the order won't be executed.

5. Not updating the form when the patient's healthcare preferences change - It's essential to keep the DNR order current to reflect any new decisions regarding resuscitation efforts.

6. Not properly distributing copies of the completed form to relevant parties, such as family members and healthcare providers, leads to a lack of awareness about the patient's DNR status.

7. Misunderstanding the scope of the DNR - Some individuals mistakenly believe that a DNR order limits other forms of medical treatment, which is not the case. It solely addresses resuscitation efforts.

8. Incorrectly thinking that a DNR order is permanent and cannot be revoked, which might discourage some from opting for it, even if it aligns with their current healthcare preferences.

9. Assuming the form is universally recognized - While a New York DNR order is valid across the state, it might not be recognized in other states without additional documentation or processes.

Avoiding these mistakes ensures that the DNR order accurately reflects the individual's wishes, protecting their rights and ensuring their medical preferences are respected.

When dealing with a New York Do Not Resuscitate (DNR) Order form, it's important to consider other documents that might be relevant to ensure that all medical and end-of-life wishes are clearly communicated and legally documented. These forms often work together to provide a comprehensive plan for healthcare professionals, family members, and caregivers. Here’s a list of documents that are commonly used in conjunction with the New York DNR Order form.

• Living Will: This document outlines a person's wishes regarding the types of medical treatments and life-sustaining measures they want or do not want if they become incapacitated and are unable to communicate their preferences.
• Health Care Proxy: A Health Care Proxy is a legal document that allows an individual to appoint someone else (a proxy) to make health care decisions on their behalf if they are unable to do so.
• Medical Orders for Life-Sustaining Treatment (MOLST): The MOLST form is used to document a person's preferences for life-sustaining treatments, including resuscitation, intubation, mechanical ventilation, and artificial nutrition and hydration.
• Power of Attorney (POA): A POA is a legal document that grants someone else the authority to make decisions on behalf of the person creating the document. This can include financial, legal, and health care decisions, depending on the type of POA.
• Last Will and Testament: This document outlines how a person’s assets and estate will be distributed after their death. It may also include funeral and burial wishes.
• Non-Hospital DNR Order: In New York, a non-hospital DNR order is used to prevent the administration of CPR in non-hospital settings, such as at home or in hospice care.
• Emergency Medical Services (EMS) Card: An EMS card is a wallet-sized card that indicates a person has a DNR order and/or other advance directives. It is designed to be easily accessible to EMS personnel in an emergency.
• Organ and Tissue Donation Registration: This document allows individuals to register their decision about organ and tissue donation upon death, which can be important information to have documented with other end-of-life plans.
• Portable Medical Orders Wallet Card: Similar to the EMS card, this card indicates that an individual has portable medical orders like a DNR or MOLST, and it often includes contact information for the individual’s healthcare proxy.

In summary, the New York Do Not Resuscitate Order form is just one piece of an individual's larger advance care planning puzzle. By incorporating additional legal and healthcare documents, individuals can ensure their wishes are known and respected. It's beneficial for individuals and their loved ones to familiarize themselves with these documents to prepare a comprehensive plan that addresses all aspects of future medical care and personal wishes.

• A Living Will is similar because it outlines a person's wishes regarding medical treatments in life-threatening situations. While a Living Will can cover a broad range of treatments, a Do Not Resuscitate Order specifically addresses the use of CPR.

• A Medical Power of Attorney (POA) designates someone to make healthcare decisions on a person's behalf when they cannot. It's like a DNR because it empowers someone else to enforce the patient’s wishes about life-saving interventions.

• Durable Power of Attorney is broader, allowing someone to make decisions beyond health care, such as financial matters. Its similarity lies in the aspect of designating decision-making authority to another, reflecting the patient’s preferences, including end-of-life care.

• A Health Care Proxy is another document that nominates a person to make healthcare decisions. This similarity to a DNR Order is in its focus on health care decisions according to the patient's wishes, potentially including the refusal of CPR.

• The Five Wishes Document goes beyond typical health care directives by addressing personal, emotional, and spiritual needs in addition to medical wishes. Like a DNR, it can specify wishes regarding life-sustaining treatment.

• A POLST Form (Physician Orders for Life-Sustaining Treatment) is an actionable medical order dealing with current health conditions. It's similar because it can include instructions not to perform CPR, aligning with what DNRs specify.

• A Living Trust is primarily used for estate planning but relates to a DNR in the way it prepares for the future, detailing how a person's assets should be handled after their death. Both documents are part of a well-rounded approach to preparing for one’s mortality.

• Advanced Health Care Directive is an umbrella term for any document that directs care when a person is incapacitated. This includes DNR orders as well as living wills and health care POAs, making it a broader framework for end-of-life planning.

• A Mental Health Advance Directive specifies preferences for mental health treatment in situations where a person may not be able to make decisions for themselves. Although focused on mental health, it shares the proactive planning aspect with a DNR order.

Filling out a New York Do Not Resuscitate (DNR) Order form is a significant step for ensuring that a person's wishes regarding emergency medical treatment are respected. Here are some important dos and don'ts to consider when completing this document:

1. Consult with a healthcare provider to understand the full implications of a DNR order before making a decision. This dialogue is crucial as it ensures that individuals are making informed choices based on their healthcare goals and values.

2. Discuss your wishes with family members or significant others. Sharing your healthcare desires with loved ones is essential as it prepares them for any decisions that may need to be made in the future.

3. Ensure that the form is properly signed and dated. Legal documents, such as a DNR order, require an authorized signature and date to be considered valid and enforceable.

4. Keep a copy of the signed DNR order in an easily accessible location. In an emergency, time is of the essence. Ensuring that the document can be quickly found by emergency personnel or family members is crucial.

5. Inform your healthcare proxy or power of attorney about the DNR order. These individuals have been designated to make healthcare decisions on your behalf and should be made aware of your wishes.

6. Review and update the DNR order as needed. As circumstances and health conditions change, it may be appropriate to revisit and potentially revise your DNR order.

7. Carry an identification card or wear a medical alert bracelet indicating your DNR status. This can be critical in ensuring that your wishes are respected, even if you are unable to communicate.

• Fill out the DNR order without fully understanding its implications. If there's any confusion or concern, it's important to seek clarification from a healthcare provider or legal professional.

• Leave sections of the form blank. Incomplete forms may not be legally valid or may lead to misunderstandings about your wishes.

• Forget to share your DNR order with your primary care physician and any specialists you may be seeing. They need to be aware of your wishes in order to provide care that aligns with your preferences.

• Assume that once the DNR order is signed, it cannot be changed. Your healthcare decisions are always yours to make, and you can update or revoke your DNR order at any time.

• Fail to use the state-specific DNR form. New York State has its own requirements and forms for DNR orders. Using the correct form ensures that your wishes are properly documented and recognized under state law.

• Neglect to discuss your decision with those closest to you. The decision to have a DNR order is personal and can be emotionally challenging. Open communication with loved ones can provide support and understanding.

• Think that a DNR order covers all forms of medical treatment. A DNR specifically relates to not receiving cardiopulmonary resuscitation (CPR) in the event that one's heartbeat or breathing stops. It is important to understand that this does not apply to other forms of medical care and that other directives may be necessary to outline wider treatment preferences.

Many misconceptions exist about the New York Do Not Resuscitate (DNR) Order form. Understanding these DNR orders is crucial for making informed healthcare decisions.

• All healthcare facilities honor your DNR order without review. Each facility has protocols for reviewing DNR orders upon a patient's admission to ensure compliance with current laws and regulations.

• A DNR order affects all medical treatments. A DNR order specifically addresses the absence of resuscitative efforts in the event of cardiac or respiratory arrest, not other forms of medical treatment or interventions.

• A DNR order can only be initiated by a doctor. While a physician must sign the order, patients or their health proxies can request its initiation based on the patient’s wishes or healthcare directives.

• DNR orders are permanent and cannot be changed. A DNR order can be rescinded or modified at any time by the patient or their legally designated health proxy.

• Only elderly patients can have a DNR order. Patients of any age can have a DNR order if deemed appropriate for their medical condition and wishes regarding end-of-life care.

• DNR orders are automatically transferred between facilities. When patients transfer between facilities, it is essential to verify that the DNR order is communicated and acknowledged by the receiving institution. Transferring documentation is the patient's or caregiver's responsibility.

• Having a DNR order means you won’t get admitted to the hospital. A DNR order does not preclude hospital admission. It specifically guides healthcare providers on the patient's wishes regarding resuscitation, not the broader scope of healthcare services.

• If you're healthy, you don't need to consider a DNR. Discussing and considering a DNR is a part of advance healthcare planning, beneficial for individuals at various stages of health, to ensure that healthcare preferences are respected.

• DNR orders are only for patients with terminal illnesses. While often associated with terminal illness, DNR orders can also be appropriate for patients with significant chronic illnesses or preferences against aggressive end-of-life interventions.

• You need a lawyer to complete a DNR order. Legal counsel is not required to complete a DNR order. The process involves the patient or their health proxy discussing with a physician, who then documents the order in the patient’s medical record.

The New York Do Not Resuscitate (DNR) Order form is an important document for individuals who wish to refuse cardiopulmonary resuscitation (CPR) in case their heartbeat or breathing stops. Understanding how to complete and use this form correctly is crucial for ensuring a person's wishes are respected. Here are five key takeaways regarding the New York DNR Order form:

• The DNR form requires clear communication between the patient (or their health care proxy) and the physician. The physician must ensure that the patient or their designated decision-maker fully understands the nature and significance of a DNR order.
• Completion and signing of the DNR form must be done by both the patient (or their health care proxy) and the physician. This dual signature requirement emphasizes the mutual agreement on the decision not to pursue CPR in emergency situations.
• The form must be readily accessible to emergency personnel. For patients residing at home, the form should be placed in a prominent location. Patients in healthcare facilities should have their DNR orders included in their medical records.
• In cases where the patient is unable to make decisions for themselves and has not appointed a health care proxy, a family member or close friend can legally consent to the DNR order on behalf of the patient, as long as they are recognized as the patient’s surrogate decision-maker.
• Revocation of a DNR order can be done at any time by the patient or their health care proxy, signaling a change in the patient’s wishes regarding CPR. This decision must also be communicated to the physician and documented appropriately.

Understanding these key aspects ensures that the process of completing and implementing a DNR order in New York is done accurately and ethically, respecting the patient's wishes regarding end-of-life care.