Fillable Do Not Resuscitate Order Document for Pennsylvania

What is a Pennsylvania Do Not Resuscitate (DNR) Order?

A DNR Order in Pennsylvania is a medical directive that instructs health care providers not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. It is a decision made by the patient or the patient's legally recognized health care decision-maker, based on the patient's wishes and medical advice.

Who can request a DNR Order in Pennsylvania?

Adult patients with a terminal condition, where death is imminent, or those who are in a state of permanent unconsciousness, can request a DNR Order. The request can also be made by a health care agent designated by the patient in a legally valid health care power of attorney, or by a family member or other legal representative if the patient is unable to communicate their own wishes.

How can one obtain a DNR Order in Pennsylvania?

To obtain a DNR Order, a discussion must first take place between the patient (or the patient's representative) and a licensed Pennsylvania physician, nurse practitioner, or physician assistant. This health care professional must agree that the DNR Order is appropriate considering the patient's medical condition and wishes. Following this, the DNR form needs to be completed and signed by the appropriate parties.

Where does a DNR Order apply?

In Pennsylvania, a DNR Order is valid in all health care settings, including hospitals, nursing homes, and in the patient's home. It is also respected by emergency medical services (EMS) personnel during transport or outside of a health care setting.

Can a DNR Order be revoked or changed?

Yes, a DNR Order can be revoked or changed at any time by the patient or the patient's legally recognized health care decision-maker. This can be done by communicating the decision to revoke or change the order verbally or in writing to a health care provider. It is important to also destroy the physical DNR order form to avoid confusion.

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 instructs health care providers not to perform CPR if a patient's breathing or heartbeat stops. A living will, on the other hand, is a broader legal document that outlines a person's wishes regarding various types of medical treatments and interventions in the event they are unable to communicate these wishes themselves.

What should be done with a completed DNR Order?

Once a DNR Order is completed and signed, it should be placed in a prominent location where it can be easily found by family members and health care providers. Additionally, family members, health care agents, and local EMS providers should be informed of the existence and location of the DNR Order. Keeping a copy with personal records and even carrying a wallet card indicating DNR status are also recommended practices.

When it comes to filling out the Pennsylvania Do Not Resuscitate (DNR) Order form, several common mistakes often occur, which could potentially compromise the effectiveness of this critical document. Understanding and avoiding these errors is essential to ensure that one's healthcare wishes are precisely followed during emergencies. One commonly observed error is the inaccurate or incomplete filling out of personal information. This mistake can lead to confusion or delays in the execution of the DNR order at critical moments when seconds count.

Another significant oversight involves not properly having the document witnessed or failing to include all necessary signatures. The Pennsylvania DNR order requires signatures not only from the individual or their legal healthcare representative but also from a physician to confirm the order's validity. Without all required signatures, the document may not be legally binding, which could result in unwanted medical interventions. Ignorance of this requirement can lead to the DNR order not being honored in an emergency.

Many people also neglect to discuss their DNR order with their family, caregivers, and healthcare providers. This mistake can lead to unexpected outcomes, as those who are unaware of the existence of a DNR order might initiate life-saving measures in contradiction to the patient's wishes. Effective communication ensures that everyone involved in the patient's care understands the DNR status, thereby preventing unnecessary and unwanted medical interventions.

Finally, the failure to review and update the DNR order periodically is a mistake that can have serious repercussions. Personal wishes and health care directives may evolve, and so might the legal requirements surrounding DNR orders. Ensuring that the DNR order reflects current laws, healthcare technologies, and personal preferences is essential for maintaining its validity and effectiveness over time. Not updating it could render the document obsolete when it is most needed.

When handling the sensitive and critical matter of end-of-life decisions, it's crucial to be thorough and well-prepared. The Pennsylvania Do Not Resuscitate (DNR) Order form is a significant document for those wishing to decline resuscitation in emergencies outside the hospital. This form is often accompanied by several other documents to ensure that a person's healthcare wishes are fully documented and respected. Each document serves a unique but complementary purpose alongside a DNR order.

• Advance Health Care Directive: This document outlines a person's healthcare preferences, including end-of-life care, beyond the scope of a DNR. It may appoint a healthcare proxy.
• Living Will: Specifically addresses the types of medical treatments and life-sustaining measures an individual wants or does not want if they become incapacitated and unable to communicate their wishes.
• Medical Power of Attorney: Designates a trusted individual to make healthcare decisions on behalf of the person if they are unable to do so themselves.
• Out-of-Hospital DNR Order: Specific to Pennsylvania, complements the DNR by providing instructions not to administer CPR if the individual is found in cardiac or respiratory arrest outside of a hospital setting.
• POLST (Physician Orders for Life-Sustaining Treatment): A physician-signed order that outlines a seriously ill or frail patient’s preferences for life-sustaining treatments, including resuscitation, mechanical ventilation, and tube feeding.
• Emergency Contact Form: Not a legal document, but important for emergency responders to quickly identify and contact the individual's designated emergency contacts.
• Health Insurance Information: Ensures that medical providers have access to insurance information for billing and verification purposes, avoiding potential delays in non-emergency treatments or procedures.

Collectively, these documents provide a comprehensive approach to managing one's health care preferences and emergencies. They should be prepared with thoughtful consideration and updated as circumstances change. To ensure these documents achieve their intended legal effect, it is advisable to consult with a healthcare professional or legal expert. The specificity and clarity with which these documents are filled out can profoundly impact the care one receives and the peace of mind they afford both the individual and their loved ones.

A living will shares similarities with the Pennsylvania Do Not Resuscitate (DNR) Order form in that it provides explicit instructions about an individual's wishes regarding medical treatment should they become unable to communicate these wishes themselves. Living wills typically outline a person's decisions about the use of life-sustaining treatments, including resuscitation, when facing a terminal illness or a permanent unconscious state. This is akin to the DNR Order, which specifically refuses resuscitation attempts in emergency situations.

Similarly, a healthcare power of attorney (POA) is related to a DNR Order in its empowerment of an individual, known as the agent, to make healthcare decisions on behalf of the person granting the power, the principal, should they become incapacitated. While a healthcare POA covers a broad range of healthcare decisions, including accepting or refusing medical treatment, a DNR Order focuses specifically on the refusal of cardiopulmonary resuscitation (CPR).

The POLST (Physician Orders for Life-Sustaining Treatment) form is closely related to a DNR Order because it also provides specific medical orders concerning end-of-life care. Created based on discussions between patients and their healthcare providers, POLST forms ensure that patients' wishes are respected across different healthcare settings. They go beyond DNR Orders by addressing treatments such as antibiotics, feeding tubes, and hospitalization, but include the option to refuse resuscitation.

Advance directives are legal documents that communicate a person's wishes about medical treatment in case they become unable to make decisions for themselves, much like the DNR Order. They commonly include a living will and a healthcare power of attorney, combining instructions for certain health care preferences and appointing someone to make decisions. The specificity of the DNR Order complements advance directives by addressing the critical decision about resuscitation directly and unequivocally.

A Medical Order for Scope of Treatment (MOST) is another document related to the DNR Order, designed to ensure that individuals with serious health conditions can have their treatment preferences honored across healthcare settings. Like a POLST, the MOST document can specify desires regarding CPR, intubation, and other life-sustaining treatments. While both forms aim to respect the healthcare wishes of individuals, the DNR Order particularly focuses on the refusal of CPR in emergency situations.

Filling out a Pennsylvania Do Not Resuscitate (DNR) Order form is an important step for individuals who wish to make clear their preferences regarding resuscitation efforts in a medical emergency. It's crucial to approach this document with care to ensure that your wishes are properly recorded and respected. Here are guidelines on what you should and shouldn't do when completing this form.

• Review the form carefully: Before filling anything out, read through the entire document to understand what information is required and how your choices will be interpreted.
• Consult with a healthcare provider: Discuss your health status and the implications of a DNR order with a doctor or nurse practitioner who can provide personalized advice based on your medical history.
• Use clear, legible handwriting: To avoid any confusion or misinterpretation, fill out the form in clear handwriting. If possible, typing the information might be even more preferable.
• Specify your decisions: Clearly indicate your specific preferences regarding resuscitation and other emergency treatments. Ambiguity can lead to unwanted medical interventions.
• Sign and date the form: Your signature, along with the date, confirms that the choices made on the form are your own and were made voluntarily.
• Keep the form accessible: Once completed, store the form in an easily accessible place and inform close family members, caregivers, and your healthcare provider of its location.

• Rush the decision: Take your time to consider all options and possible outcomes. This is a significant decision that should not be made in haste.
• Leave blanks on the form: Incomplete forms may lead to uncertainty in an emergency situation. If a section does not apply, clearly mark it as "N/A" for "Not Applicable."
• Use technical or ambiguous language: Stick to simple, straightforward language to convey your wishes. Avoid medical jargon that could be misunderstood.
• Forget to update the form: Life circumstances and health conditions change. If your wishes evolve, complete a new form to reflect these changes.
• Fail to communicate your wishes: Simply filling out the form is not enough. Discuss your decisions with your family, caregivers, and healthcare providers to ensure they understand and respect your wishes.
• Rely on a single copy: Make several copies of the completed form. Provide one to your primary healthcare provider, and consider carrying a copy with you.

There are several common misconceptions about the Pennsylvania Do Not Resuscitate (DNR) Order form. These misunderstandings can lead to confusion about its purpose, who it is for, and how it operates. It’s important to clear up these misconceptions to ensure individuals can make informed decisions about their healthcare preferences. Below are nine misconceptions about the Pennsylvania DNR Order form.

• A DNR order is only for the elderly or those in hospice care. This is a misconception because a DNR order can be appropriate for patients of any age who want to avoid aggressive measures to restart their heart or breathing, regardless of their overall health condition or age.
• Having a DNR order means you won’t get any medical treatment. This is not accurate. A DNR order specifically addresses cardiopulmonary resuscitation (CPR) in the event the heart stops or breathing ceases. It does not mean that other forms of medical care and treatment will be withheld.
• You need a lawyer to complete a DNR order. This is incorrect. While legal advice can be beneficial in many healthcare decisions, completing a DNR order in Pennsylvania does not require a lawyer. The form needs to be filled out by the individual (or their legal healthcare decision-maker) and their physician.
• A DNR order goes into effect as soon as it is signed. While this can be true, a DNR order must be appropriately documented and recognized by medical personnel to take effect. Simply filling out the form without ensuring it is properly integrated into the patient’s medical records may not ensure its recognition in an emergency.
• DNR orders are irreversible. This is a misconception. DNR orders can be revoked or altered at any time by the individual or their proxy as long as the individual is capable of making their own healthcare decisions.
• Only the patient can request a DNR order. While the patient’s wishes are paramount, in cases where the patient is unable to communicate their desires, a designated healthcare proxy or power of attorney for healthcare decisions can request a DNR order on their behalf, based on previously expressed wishes of the patient or in the patient's best interest.
• All healthcare providers must honor a DNR order. Ideally, yes, but in reality, the presence and recognition of a DNR order can vary, especially outside of hospital settings. It’s crucial that DNR orders are clearly communicated and documented across all care settings.
• A DNR order can be transferred between states. While some states have reciprocity agreements or may respect an out-of-state DNR order, it is always best to verify and, if necessary, complete a new DNR order that complies with the specific statutes and regulations of the state in which you are currently receiving care.
• DNR orders only apply in a hospital setting. This is not true. DNR orders can also be applied in other settings, such as at home or in a nursing home. However, the implementation of DNR orders in non-hospital settings requires clear communication with and education of all caregivers and must be part of the patient’s care plan.

It is always advisable for individuals considering a DNR order to discuss their wishes and concerns with healthcare professionals and loved ones to ensure their preferences are understood and respected.

The Pennsylvania Do Not Resuscitate (DNR) Order form is a critical document for individuals who wish to decline certain life-sustaining treatments in specific medical situations. Understanding the key takeaways about filling out and using this form can ensure that a patient's wishes are respected and clearly communicated to healthcare providers. Here are six essential points to note:

• Eligibility Criteria: Ensure the person meets the eligibility requirements for a DNR order in Pennsylvania, which typically include patients with terminal conditions, irreversible states, or specific directions in their living will.
• Physician’s Role: A licensed physician must be involved in the process, as they are required to sign the DNR order, confirming the patient's medical condition and decision-making capacity.
• Clear Communication: Discuss the decision with family members, healthcare agents, and other relevant parties to ensure everyone understands the patient's wishes regarding resuscitation efforts.
• Completing the Form: Accurately complete all sections of the DNR form to avoid confusion or delays in emergencies. This includes personal information, medical condition details, and the specific treatments to be declined.
• Legal Validation: Ensure the form is legally validated as per Pennsylvania state laws, which may involve specific signing requirements or the need for witnesses.
• Accessibility of the Form: Keep the DNR order in an easily accessible location and inform family members, healthcare proxies, and primary care physicians of its location. Consider also carrying a DNR identification (such as a bracelet) that can speak for the patient when they cannot communicate their wishes directly.

Following these guidelines can help ensure that the DNR order accurately reflects the patient's wishes and is executed as intended during critical medical situations.