In New York State, the Do Not Resuscitate order (DNR) was established in 1985 by a task force then overseen by Governor Mario Cuomo. It was established to resolve legal issues arising out of the refusal to provide end-of-life treatment. A DNR is a medical directive that applies only to incidents of cardiac arrest. It precludes the use of cardiopulmonary resuscitation in hospitals, nursing homes, and mental health facilities. Whereas, a Living Will is a legal document that indicates an individual’s wishes for end-of-life treatment, such as refusing a feeding tube, surgeries, or blood transfusions.
A qualified physician must sign a DNR form that is issued by the Department of Health in order for it to be valid. Additionally, it must be placed in the patient’s file. The patient must also sign the DNR. If the patient lacks mental capacity, a health care agent or family member may sign on his or her behalf. It is important to regularly review the DNR. A physician should review a DNR every 5-7 days on average for patients in a hospital.
In 1991, New York Public Health Law was expanded to include a non-hospital DNR to cover the refusal of cardiopulmonary resuscitation in situations outside of an institution. Emergency service workers such as first responders most commonly encounter a non-hospital DNR. It is also used for patients who are receiving care at home. Legally, EMS workers must honor a non-hospital DNR. However, an EMS worker may perform CPR under the following circumstances:
- He or she, while acting in good faith, reasonably believes the consent on the DNR is not valid; and
- The family at the scene object to the DNR and confrontation is likely.
Doctors may object to a non-hospital DNR for the same reasons as well as for any other medical circumstance that may warrant the refusal to adhere to the order. If a patient is admitted to a hospital with a non-hospital DNR then it must be treated as a traditional DNR. A DNR is effective until it is revoked or canceled by a physician. A non-hospital DNR must also be signed using a form issued by the Department of Health. It should also be reviewed every 90 days.
At Tully Law, PC, we understand that estate and elder planning can be both emotional and overwhelming. Our attorneys are available to advise you on complex estate planning and elder law issues so as to minimize the possibility of any problems. We will take the time to review your goals and circumstances, and do our best to ensure that your assets are protected and your wishes will be carried out as per your estate plan. For more information regarding our services or to schedule a consultation, call (631) 424-2800.