What Is a DNR Form?
A DNR form is a legally recognized medical directive that instructs healthcare providers not to perform CPR if a person’s heart stops or they stop breathing. It does not prevent other treatments, including pain management and palliative care, to ensure comfort.
Laws regarding withholding resuscitation vary by state. Most require the patient, physician, and in some cases, a notary or witnesses to sign the document for it to be legally valid.
This form is often used by elderly individuals or those with serious medical conditions where a full recovery is unlikely. In some states, DNR orders may be referred to as:
- DNAR (Do Not Attempt Resuscitation)
- AND (Allow Natural Death)
- POLST (Physician Orders for Life-Sustaining Treatment)
- MOLST (Medical Orders for Life-Sustaining Treatment)
Signing Requirements
DNR orders typically require signatures from a doctor, witnesses, or a notary public. State laws vary, so review local signing requirements before completing your form.
What Does Resuscitate Mean?
In medical terms, resuscitate refers to procedures used to revive an unconscious person or someone near death. In the context of a DNR order, resuscitation specifically refers to cardiopulmonary resuscitation (CPR).
Resuscitation methods include:
- Cardiac compressions (chest compressions)
- Defibrillation (electrical shock)
- Artificial ventilation (mouth-to-mouth breathing)
- Intubation (advanced airway management with a respiratory tube)
A do not resuscitate form ensures that none of these procedures are performed if the patient experiences cardiac or respiratory arrest.
DNR vs Living Will
End-of-life planning involves legal documents that clarify medical treatment preferences. Two commonly used directives are a do-not-resuscitate order and a living will, but they serve different purposes.
A DNR order instructs healthcare providers not to perform CPR if a person’s heart stops or they stop breathing. It applies specifically to resuscitation procedures like chest compressions, intubation, and artificial respiration.
A living will, also known as an advance directive, provides broader instructions about medical care decisions beyond resuscitation. It can outline preferences for:
- life support and ventilators
- artificial nutrition and hydration
- organ donation and palliative care
Both documents help ensure that medical treatment aligns with personal wishes, but a living will covers a wider range of life-sustaining treatments. Having both can provide comprehensive end-of-life care planning.
When Is a DNR Form Appropriate?
A DNR order is put into effect when a person has a background of chronic disease or terminal illness, which has previously or might in the future require CPR, and that patient, due to concerns regarding the potential failure of CPR and the risk of sustaining brain damage or impairment, expresses their wish not to be resuscitated.
Scenario #1: Patients / Individuals Diagnosed with a Terminal Condition
For anyone diagnosed with a painful or terminal condition, DNR orders can help avoid prolonged suffering. Choosing to withdraw resuscitation in the event of a cardiac or respiratory arrest does not mean palliative care will be withheld. That is to say, administering pain-relieving medication and comfort care will still be offered, should you desire.
Scenario #2: Elderly Individuals
Another essential factor to remember is the age when debating whether a DNR form suits you. Resuscitation is an intense and often traumatic medical procedure that elderly individuals may have trouble recovering from should it be successful.
Scenario #3: Religious Values
Contrary to what some may think, signing a do-not-resuscitate order is not prohibited in the eyes of many religious institutions. Patients should consider their ethics and religious values before authorizing any end-of-life planning documentation.
What Happens if a DNR Is Not Followed?
If a DNR order is not followed, a patient may receive unwanted medical interventions that go against their documented wishes. Healthcare providers and institutions are legally required to honor a valid DNR. Failure to do so can lead to medical malpractice claims, civil lawsuits, or disciplinary action.
A DNR order is a legally binding document. Once signed and included in a patient’s medical records, all treating physicians must follow it.
Family members cannot override a DNR unless the patient has legally authorized a healthcare representative to make medical decisions on their behalf. If a medical power of attorney is in place, the designated agent must follow the patient’s expressed wishes. Otherwise, only the patient can revoke the order.
Considerations Before Signing a DNR
A DNR order is a significant decision that affects how emergency and medical teams respond in a crisis. Before signing, it’s important to understand what a DNR covers, how it differs from other medical directives, and what steps you can take to ensure it aligns with your long-term healthcare plan.
A DNR Does Not Stop All Medical Care
A DNR order only applies to CPR and advanced resuscitation efforts. You can still receive:
- Pain management, including medication and palliative care
- Treatments for infections, injuries, or other medical conditions
- Oxygen or non-invasive comfort measures
Discussing the Decision with Loved Ones
Talking to your family, caregivers, and medical proxies can help prevent confusion and ensure your decision is respected. Consider:
- Your medical prognosis and whether CPR would improve quality of life
- Any personal or religious beliefs that influence your choice
- How your decision fits within your broader estate and healthcare planning
Aligning a DNR with Other Legal Documents
To ensure a DNR order is legally valid, it should be included in your advance directive or living will. You may also want to:
- Assign a medical power of attorney to make healthcare decisions if needed
- Review state laws to confirm your DNR will be honored in all settings
- Inform your doctor, hospital, and emergency medical services about your DNR
Taking these steps helps ensure your medical preferences are clearly documented and followed in an emergency.
How to Get a DNR Order
A DNR order must be properly completed, signed, and stored in an accessible location to be legally recognized.
1. Obtain and Complete the DNR Form
A DNR form can be obtained from:
- Your doctor or hospital
- Your state’s Department of Health
- A trusted online legal provider like Legal Templates
The form typically requires a physician’s signature and, in some states, additional signatures from witnesses or a notary public.
2. Store Your DNR Where Medical Teams Can Find It
For a DNR order to be effective, emergency responders need to quickly locate it. Keep it:
- In your medical records at hospitals or clinics
- In a visible location at home, such as the refrigerator or bedside table
- With your medical ID or in a health app
- On a DNR bracelet or necklace, which some states require for recognition outside hospitals
Some states require DNR forms to be printed on specific colored paper to be legally valid. Check your state’s requirements before finalizing your document.
3. Notify Family, Caregivers, and Medical Professionals
Your family, doctors, and healthcare proxies should be aware of your DNR order. Provide copies to:
- Your primary care physician and specialists
- Any hospital, nursing home, or assisted living facility where you receive care
- Your emergency contacts or legal representatives
Taking these steps ensures your DNR is honored in both hospital and non-hospital settings.
How to Write a Do Not Resuscitate Order
Filling out a do-not-resuscitate order ensures your medical preferences are clearly documented and legally recognized. Follow these steps to complete the form accurately:
- Enter the patient’s information including their full legal name and whether a legal representative is authorized to make decisions on their behalf
- Provide the physician’s details such as the physician’s full name and contact information
- Include final details like the governing state, date of the order, and signatures from the physician, witness, or notary if required
Completing these steps ensures that your DNR order is valid and properly recorded in your medical records.
How to Revoke a DNR
A DNR order can be revoked or changed at any time, even in a medical emergency. To ensure your updated preferences are followed, take these steps:
1. Inform Your Doctor
Your physician must remove the DNR order from your medical records if you decide to cancel it. Some states also require a written revocation request.
2. Destroy Old Copies
Once revoked, remove all physical and digital copies to prevent confusion. This includes:
- Shredding or discarding printed DNR forms
- Removing DNR bracelets or necklaces
- Updating your Advance Directive or Medical Power of Attorney
3. Notify Family and Healthcare Providers
To avoid misunderstandings, inform family members, caregivers, and any medical institutions where your previous DNR order was filed. Providing them with an updated healthcare directive ensures your current wishes are followed.
By following these steps, you can be confident that your medical preferences remain up-to-date and legally recognized.
Laws and Signing Requirements – by State
The following table shows which states require signatures from patients, physicians, witnesses, a notary public, or some combination of each for a do-not-resuscitate order to be legally valid:
| State | Who Needs to Sign? | Legal Code |
|---|---|---|
| Alabama | Patient and Physician | AL Code § 420-5-19-.02 |
| Alaska | Patient and either a Witness, Notary Public, or Physician | AK Stat 13.52.150 |
| Arizona | Patient, Physician, and Witness | AZ Rev Stat § 36-3251 |
| Arkansas | Patient and either a Notary Public or 2 Witnesses | AR Code § 20-13-901 |
| California | Patient and Primary Physician | CA Prob Code § 4780 |
| Colorado | Patient and Attending Physician | CO Rev Stat § 15-18.6-103 |
| Connecticut | Patient and Physician | CT Gen Stat § 19a-580d |
| Delaware | Patient and 2 Witnesses | 16 DE Code § 2505 |
| Florida | Patient and Primary Physician | FL Stat § 401.45 |
| Georgia | Patient and Attending Physician | GA Code § 31-39.6.1 |
DNR Form Sample
You can view a DNR order template below as an example for creating your own. Customize this template using Legal Templates’ document editor.
Finalizing Your DNR Order
Creating a do-not-resuscitate order ensures your medical wishes are clearly documented and respected. While this guide provides an overview, consulting a legal or healthcare professional can offer additional guidance. Legal Templates simplifies the process with customizable forms designed to make document creation straightforward and stress-free.
Frequently Asked Questions
Can anyone get a DNR order?
Not everyone can get a DNR order. In most cases, a patient must be an adult and have the mental capacity to make medical decisions. If a person is unable to decide, a legally designated healthcare proxy or power of attorney may request a DNR on their behalf.
Does a DNR order apply outside of a hospital?
A DNR order may not always apply outside a hospital. Some states require a DNR bracelet or specific documentation for emergency responders to honor it. To ensure your wishes are followed, check local requirements and provide copies to your doctors and caregivers.
Do DNR forms expire?
DNR forms do not automatically expire, but they should be reviewed periodically. Changes in state laws, medical conditions, or personal preferences may require updates. Some states require renewal after a certain period, so check with your healthcare provider to ensure your form remains valid.