Every mentally competent patient has the right to either accept or refuse any medical treatment recommended to him or her by healthcare providers and medical professionals. This right has been called “a fundamental principle of liberty” and patients may exercise it even if the treatment offered is considered to be lifesaving. In the US, this right is guaranteed by law and enshrined in the American Hospital Association Patient’s Bill of Rights. These legal protections prevent medical professionals from forcing a mentally competent, adult patient to accept treatment even in life-threatening situations.
If a person experiencing a medical event is unconscious and cannot communicate his or her wishes with regards to medical procedures, some individuals carry a DNR or Do Not Resuscitate order with them. A DNR order is designed to prevent medical staff and other persons from performing CPR on the person. In this article, we will offer a brief overview of what this document includes and how to create it. If you’re not sure if a DNR order is right for you, speak with a qualified New Jersey estate planning attorney today.
The Matus Law Group can provide clarity on DNR orders and their implications in New Jersey. We can help individuals and families understand the nuances of DNR orders, as well as the importance of having a healthcare proxy, to properly document and legally uphold your healthcare wishes. Contact us today at (732) 785-4453 to schedule a consultation and safeguard your peace of mind when planning for the future.
What is a DNR?
The Do Not Resuscitate (DNR) directive serves as a formal communication to healthcare professionals, indicating your preference not to undergo resuscitation efforts. This directive is most relevant in scenarios where there might otherwise be an application of Cardiopulmonary Resuscitation (CPR) to restore heart and respiratory functions. It also signifies a decision against the use of defibrillation and certain medications designed to either boost heart rate or hinder blood clot formation.
A DNR order is often a component of a more comprehensive framework that includes Medical Orders for Life-Sustaining Treatment (MOLST). This framework covers considerations like intubation, mechanical ventilation, prolonged coma management, and dialysis. The establishment of both these orders requires a substantial discussion between you and your physician, primarily intended for individuals who are elderly or dealing with an advanced terminal illness.
If you possess a DNR, it’s crucial to engage in a conversation with your family about your preferences. Frequently, emotional distress can arise within families when a loved one’s desire to avoid resuscitation has not been communicated beforehand. It’s important to clearly convey your wishes to your family and those individuals responsible for your medical care, outlining your exact expectations in the event of your passing.
If you’re considering a DNR directive in New Jersey, an experienced estate planning attorney can guide you through the legal and medical intricacies of this important decision. At The Matus Law Group, our team of dedicated New Jersey estate planning attorneys can guide you through the process of creating comprehensive advance care directives, such as a DNR order, and integrate them into your overall estate plan. Contact us to schedule a consultation and receive assistance tailored to your unique needs.
What Should a DNR Order Include?
A typical DNR order may state that the person who carries it doesn’t want to undergo any procedure whose aim is to restore blood circulation and heartbeat in the event of cardiac arrest. Such procedures include CPR, intubation to connect the patient to a breathing machine, electric shocks, and emergency medications.
In New Jersey, a patient may obtain a DNR order both in and out of a hospital setting. A legally valid DNR order can also be requested and authorized by a health care agent. Additionally, DNRs can be established by a doctor if the patient is unable to communicate but has a valid living Will or advance health care directive in place that clearly states his or her wishes.
Can Anyone Get a DNR?
In New Jersey, obtaining a Do Not Resuscitate (DNR) order involves a formal process governed by specific regulations. A DNR can be issued for patients in healthcare facilities under the guidelines of N.J. Admin. Code § 15A:3-2.5, ensuring that the decision is both informed and respects the patient’s wishes and medical condition.
The process begins with a thorough discussion between the attending physician or an advanced practice nurse (APN) and the patient. If the patient is unable to make decisions due to incapacity, this discussion extends to a surrogate decision-maker such as a legal guardian, closest relative, or an appointed healthcare proxy who can make such decisions. For patients with a court-appointed guardian, the physician must consult this guardian before proceeding.
If a patient is capable of making their own healthcare decisions, they may request a DNR, provided that the physician confirms the patient fully understands their medical condition, as well as the consequences and implications of the DNR order. This includes an understanding of the risks, benefits, and any possible alternatives to a DNR. For cases where a DNR order exists from a previous hospitalization, it must be reviewed and possibly rewritten to align with the current facility’s policies once the patient is transferred.
Proper documentation is a key part of this process. The healthcare provider must record the patient’s medical condition, diagnosis, and prognosis, as well as details of the discussion about the DNR order. This ensures that the decision is well-informed and tailored to the specific circumstances of the patient.
While not everyone can directly request a DNR, individuals in New Jersey healthcare facilities who meet the necessary medical and legal criteria can have a DNR order issued, with the process safeguarded to respect their autonomy and medical needs.
DNR Orders vs. Advance Healthcare Directives
Although not the same, Do Not Resuscitate orders fall into the same category as Advance Healthcare Directives. The purpose of such documents is to allow an individual to express their wishes with regards to medical procedures they wish to accept or reject in advance in case they are unable to make such decisions themselves. It is important to note, however, that while a DNR order may be a part of an Advance Healthcare Directive, it is also possible to establish such an order as an independent document. In other words, a person doesn’t have to have an Advance Directive to be able to create a DNR order.
| Topic | Details |
|---|---|
| Content of a DNR Order | A typical DNR order specifies that the individual does not want certain life-saving procedures, including CPR, intubation, electric shocks, and emergency medications, in the event of cardiac arrest. |
| Obtaining a DNR Order in New Jersey | In New Jersey, a DNR order can be obtained both within and outside a hospital. It can also be authorized by a health care agent. Doctors can establish DNR orders for patients who cannot communicate but have valid living wills or advance health care directives outlining their wishes. |
| DNR Orders vs. Advance Healthcare Directives | DNR orders and Advance Healthcare Directives serve a similar purpose, allowing individuals to express their medical procedure preferences in advance. While a DNR order may be part of an Advance Directive, it can also exist as an independent document, not requiring an Advance Directive. |
If you have any other questions about legal documents related to your treatment preferences or if you would like to create any such documents, do not hesitate to contact the Matus Law Group. During a personal consultation, a member of our team may help you better understand your needs and advise you with regards to legal tools such as a living Will, advance health care directive, and medical power of attorney. Contact us today to schedule your consultation.
