Attorney-Verified Pennsylvania Do Not Resuscitate Order Form

When considering the Pennsylvania Do Not Resuscitate Order (DNR) form, it's important to understand its purpose and how to use it effectively. Here are some key takeaways:

• The DNR form allows individuals to express their wish not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
• It must be signed by a physician and the patient or their authorized representative to be valid.
• Once completed, the form should be kept in an easily accessible location, such as with medical records or on the refrigerator.
• Healthcare providers must honor the DNR order; it is legally binding in Pennsylvania.
• Patients can revoke or modify the DNR order at any time, as long as they are competent to make that decision.
• It’s advisable to discuss your wishes with family members and healthcare providers to ensure everyone understands your preferences.

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

A Do Not Resuscitate Order is a legal document that allows a person to refuse certain medical interventions in the event of a medical emergency. In Pennsylvania, this order specifically instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if the patient stops breathing or their heart stops beating. It reflects a person's wishes regarding end-of-life care.

Who can create a DNR Order in Pennsylvania?

In Pennsylvania, any adult who is capable of making their own medical decisions can create a DNR Order. This includes individuals who are 18 years or older. If someone is unable to make decisions for themselves, a designated healthcare representative or a legal guardian may be able to create the order on their behalf.

How do I obtain a DNR Order form?

You can obtain a DNR Order form from various sources, including hospitals, healthcare providers, and the Pennsylvania Department of Health website. It’s important to ensure that you are using the most current version of the form to avoid any issues with validity.

What information is required on the DNR Order form?

The DNR Order form typically requires personal information, such as the patient's name, date of birth, and address. It also requires the signature of the patient or their authorized representative, as well as the signature of a physician. The form may include additional details about the patient's medical condition and preferences for care.

Does a DNR Order apply outside of a hospital setting?

Yes, a DNR Order can apply outside of a hospital setting, but it must be properly completed and signed. Emergency medical personnel, such as paramedics, are required to honor a valid DNR Order in any location, provided they have access to the form. It’s advisable to keep a copy of the order in a visible location, such as on the refrigerator or with your medical records.

Can a DNR Order be revoked?

Yes, a DNR Order can be revoked at any time. The patient or their authorized representative can simply destroy the form or inform healthcare providers that they no longer wish to have the order in place. It’s important to communicate any changes to your healthcare team to ensure that your current wishes are respected.

What happens if a DNR Order is not followed?

If a valid DNR Order is not followed, it can lead to unwanted medical interventions, which may cause distress for both the patient and their family. Healthcare providers are legally obligated to honor the wishes expressed in a DNR Order. If a situation arises where a DNR is ignored, it may be necessary to address the issue with the healthcare provider or facility involved.

Are there any alternatives to a DNR Order?

Yes, there are alternatives to a DNR Order, such as advance directives and living wills. These documents allow individuals to express their wishes regarding various aspects of medical care, not just resuscitation. They can provide guidance on other treatments and interventions, ensuring that a person's healthcare preferences are honored even if they are unable to communicate them at the time.

Pennsylvania Do Not Resuscitate Order - Usage Instruction

Filling out the Pennsylvania Do Not Resuscitate Order form is an important step in expressing your healthcare preferences. It allows you to communicate your wishes regarding resuscitation in a clear manner. Below are the steps to complete the form accurately.

1. Obtain the Pennsylvania Do Not Resuscitate Order form. You can find it online or request a copy from your healthcare provider.
2. Begin by filling in your personal information. Include your full name, date of birth, and address.
3. Next, indicate whether you are filling out the form for yourself or on behalf of someone else. If it is for someone else, include their name and relationship to you.
4. Read the instructions carefully. Make sure you understand what each section requires.
5. In the appropriate section, indicate your wishes regarding resuscitation. You may check the box that aligns with your preferences.
6. Sign and date the form. If you are completing it on behalf of someone else, include your signature as the authorized representative.
7. Have the form witnessed. Pennsylvania requires that the form be signed by two witnesses who are not related to you and do not stand to gain from your death.
8. Make copies of the completed form. Keep one for your records and provide copies to your healthcare provider and family members.

Once you have completed the form, ensure that it is easily accessible to your healthcare team. It is crucial that your wishes are known and respected during medical emergencies.