What’s the Difference between a Do-Not-Resuscitate Order and an Advance Directive?
Recently, a client asked me, “What’s the difference between a do-not-resuscitate order and an advance directive?” Since many people (including some medical professionals) are confused about this, I thought I’d devote a blog post to the topic.
A do-not resuscitate order says that if your heart stops beating, or if you stop breathing, you don’t want to be resuscitated.
An advance directive is more general. You can specify your wishes if you are incapacitated. In an advance directive, you can also give directions about organ donation, and name a health care proxy to make decisions for you if you become incapacitated.
What is a do-not-resuscitate order?
A do-not-resuscitate (DNR) order says that if your heart stops beating or if you stop breathing, a health care provider may not use any medical procedure to restore breathing or heart function.
DNR orders are governed by the Oklahoma Do-Not-Resuscitate Act. This act has a template for a DNR order; if you sign this template, it will be legally binding. See the Oklahoma Do-Not-Resuscitate Act here. See the DNR form template here.
You may revoke a DNR order in the following ways:
By destroying the form, and removing DNR identification from your person. You must also notify your attending physician of the revocation.
A parent or guardian or a minor child may revoke a DNR order by communicating the revocation to a physician or other health care provider. A minor child may also revoke a DNR order, if the minor has “sufficient understanding and appreciation of the nature and consequences of the treatment decision. The minor must communicate the revocation to a physician or other health care provider.
A “representative” may revoke a DNR order by notifying the attending physician or health care provider, or by destroying the DNR order and notifying the attending physician. Under the Do-Not-Resuscitate Act, a “representative” includes:
A court-appointed legal guardian of an adult, (to read more about guardians, click here)
A health care proxy under the Oklahoma Advance Directive Act, (for more information about health care proxies, see below)
An attorney-in-fact for health care decisions under the Oklahoma Health Care Agent Act (for more information about health care agents, click here)
What is an advance directive?
An advance directive is considerably broader than a DNR order. In an advance directive, you state what you want to happen to you if you become incapacitated and are unable to make an informed decision about your health care. You may specify that:
You don’t want life-sustaining treatment, but you do want food or water
You don’t want life-sustaining treatment, and you do not want food or water either, or
You want life-sustaining treatment, and food and water.
You can also write in whatever you want on an advance directive. The legislature has created a form that is flexible, so that you can customize it to state your wishes.
An advance directive, where you state that you do not want life-sustaining treatment, is often called a “living will.” An advance directive, where you state that you do want life-sustaining treatment, is sometimes called a “will to live.”
In an advance directive, you may also name someone as your health care proxy to make decisions for you. You may also state whether you want your organs donated.
Advance directives are governed by the Oklahoma Advance Directive Act. In this act, there is also a form template for an advance directive. The Oklahoma Advance Directive Act is available here. The form template is available here.
Either an advance directive, or a DNR order, may direct that life-sustaining treatment not be performed on you in the event of cardiac or respiratory arrest.
You may revoke an advance directive in any manner by communicating the revocation to your attending physician or health care provider.
Another difference between an advance directive and a DNR order: someone else may sign a DNR order on your behalf.
If a court has appointed someone to be your legal guardian, or if you have designated that person your attorney-in-fact under the Oklahoma Health Care Agent Act or as your proxy under the Oklahoma Advance Directive Act, that person may sign a do-not-resuscitate order for you. A guardian, or an attorney-in-fact, or proxy, may not sign an advance directive for you.
Also, as stated above, your legal guardian, attorney-in-fact, or health care proxy may revoke a DNR order for you. However, a legal guardian, attorney-in-fact, or health care proxy, may not revoke an advance directive for you.
Need help? Contact the Persaud Law Office
The Persaud Law Office has helped many clients put their end-of-life decisions in writing. If you have questions about DNR orders or advance directives, please don’t hesitate to give us a call.