It is important to start thinking about, and preparing for, the unexpected. Many people will wait until they become older to think about end of life issues, but accidents and disability can put tough decisions in front of families sooner than they anticipated. Advance directives help to ensure that your preferences for medical treatment are met and carried out when you’re unable to communicate them yourself. There are various types of these directives – such as DNR orders and Directives to Physicians. They’re not as similar as you might think.
WHAT DOES "DNR" MEAN? A Do Not Resuscitate (DNR) order is a type of advance directive, which indicates that you do not wish to receive CPR should your heart stop beating or you stop breathing. Without a DNR order in place, medical personnel will always attempt to help any patient in this scenario, regardless of the consequences. These orders are in place to not only prevent CPR from being administered, but also the use of artificial breathing tubes, electric heart shocks, and any other invasive emergency techniques.
There are two different types of DNR orders. An out-of-hospital, or prehospital, DNR order (called a POLST in Washington) provides emergency medical personnel who may treat you with directions to not revive you. If you’ve been admitted to a hospital, you can submit a separate DNR order that will be noted on your medical chart. Hospitals and doctors in every state are required to accept DRN orders.
A DNR order isn’t for everybody. Most who consider it are either terminally ill or are at a high risk for cardiac or respiratory arrest. It’s important to note that DNR orders are never permanent, and can be revoked at any time, should you choose to change your mind. You should consult with your doctor before signing a DNR for yourself or a loved one.
WHAT IS A DIRECTIVE TO PHYSICIANS? A Directive to Physicians is another type of advance directive. It helps you communicate your wishes regarding future medical treatment when you’re no longer able to do so because of an illness or injury. You can specify for the withholding or provision of medical care should you be diagnosed with a terminal/irreversible condition – as long as the condition is certified by your physician.
Take some time to discuss these wishes with your family, and especially with your physician, as they may be able to provide you with valuable resources to assist you in finalizing your directive.
Be sure copies of this directive get distributed to your doctor, local hospital, family, or person holding your health care power of attorney. You will also need to provide guidance to them on the specifics of your treatment that is listed in the directive. You can also provide additional instruction and peace of mind to your family and loved ones by providing a written plan of care that is drafted with the assistance of a lawyer or social worker. Also, consider reviewing your advance directives periodically, in case your preferences or persons making the decisions for you happen to change over time.
HOW ARE THEY DIFFERENT? Though a DNR order and a Directive to Physicians are both advance directives, they both serve a different purpose for different people. Whereas a Directive to Physicians is imperative for everyone to prepare at some point in their lives, DNR orders are more for those who expect to have a medical emergency either at home or in public.
Simply think of it this way: a Directive to Physicians describes the treatment (or lack thereof) you wish to receive in the future when you become too impaired to make decisions. DNR orders are implicit, and describe what should happen to you in the exact moment that you become incapacitated.
If you have questions about these or other estate planning issues, give us a call at 253.858.5434 to set up an appointment today. We represent clients throughout Washington and Idaho and are available to meet in person, by phone, or via Skype or FaceTime.