Legal Maryland Do Not Resuscitate Order Form

1. What is a Do Not Resuscitate (DNR) Order in Maryland?

   A Do Not Resuscitate (DNR) Order in Maryland is a legal document that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a person's breathing stops or if the heart stops beating. It is intended for individuals who want to decline life-extending treatments in these situations. This document must be completed in consultation with a healthcare provider and reflects the individual's wishes regarding end-of-life care.

2. How can someone obtain a DNR Order in Maryland?

   To obtain a DNR Order in Maryland, an individual must discuss their healthcare wishes with a licensed healthcare provider. This discussion ensures that the individual fully understands the implications of a DNR Order and that it aligns with their end-of-life care preferences. After this consultation, the healthcare provider will complete and sign the DNR Order. It is crucial that this form is kept in an easily accessible place where it can be quickly provided to healthcare professionals in an emergency.

3. Who should consider having a DNR Order?

   • Individuals with a terminal illness who wish to decline life-saving treatments.
   • Persons with severe chronic conditions where CPR may not improve the quality of life or may result in significant suffering.
   • Anyone who wants their end-of-life care wishes to be clearly documented and respected.

4. Can a DNR Order be revoked or changed in Maryland?

   Yes, a DNR Order can be revoked or changed at any time by the person who requested it. To revoke or alter a DNR Order, the individual must inform their healthcare provider of their new wishes. A new discussion will then take place to ensure the updated decisions regarding CPR and end-of-life care are documented and understood. It is important to communicate any changes to a DNR Order to all involved in the individual’s care to ensure that their current wishes are followed.

Completing a Maryland Do Not Resuscitate (DNR) Order form requires attention to detail and an understanding of its clauses. Mistakes in this process can have significant consequences, potentially leading to unwanted medical interventions. One common error is not properly verifying the patient's identity. This step is crucial. Without correct patient information, including full name and date of birth, the DNR order might not be recognized or could be applied to the wrong individual, defeating its purpose.

Another frequent mistake is failing to secure the necessary signatures. For a DNR order to be valid in Maryland, it must be signed by the patient (or their authorized representative) and their physician. Skipping this step or leaving out a signature can invalidate the entire document. This oversight can lead to medical teams administering life-saving procedures that the patient intended to decline, simply because the paperwork was not in order.

There's also the error of not discussing the decision with healthcare providers. Completing a DNR form without a thorough conversation with a physician or medical advisor can lead to misunderstandings about what the DNR order entails and when it applies. Such discussions ensure that all parties understand the patient's wishes and the circumstances under which the DNR will be respected, which is crucial for it to be effectively implemented.

Lastly, neglecting to review and update the document as needed can significantly impact its effectiveness. People's wishes and health status can change over time. A DNR order that was filled out years ago may not reflect the current wishes of the patient. Regularly reviewing and, if necessary, updating the DNR ensures that it accurately represents the patient's current desires regarding life-sustaining treatment.

When preparing for healthcare and end-of-life decisions in Maryland, the Do Not Resuscitate (DNR) Order form is a crucial document that tells healthcare professionals not to perform CPR if a person's breathing or heartbeat stops. However, this form is often accompanied by other important documents to ensure a person's healthcare wishes are fully understood and respected. Here are five such forms and documents that are frequently used alongside a Maryland DNR Order.

• Advance Directive: This includes a Living Will and a Health Care Power of Attorney. The Living Will specifies the kinds of medical treatments a person wishes or does not wish to receive towards the end of their life. The Health Care Power of Attorney appoints someone to make healthcare decisions on behalf of the person if they are unable to speak for themselves.
• Medical Orders for Life-Sustaining Treatment (MOLST): This is a clinical process designed to facilitate conversations about life-sustaining treatments between health care providers and patients. The MOLST form documents those discussions and ensures the patient's wishes are followed by all healthcare providers, across settings.
• HIPAA Authorization Form: The Health Insurance Portability and Accountability Act (HIPAA) protects a person’s health information. A HIPAA Authorization Form allows healthcare providers to share a person’s health information with specified individuals, typically family members or caretakers, not otherwise authorized under law.
• Durable Power of Attorney for Finances: While not a healthcare document per se, this form complements a person's healthcare planning by appointing someone to handle their financial affairs if they are incapacitated. This can be crucial for managing the cost of healthcare and ensuring the person’s financial affairs are in order during illness or recovery.
• Five Wishes: This is a document that combines a Living Will and Health Care Power of Attorney, but also addresses matters of comfort care, spiritual wishes, and personal matters. It is designed to be easily understood and helps guide conversations among family members and with healthcare providers regarding end-of-life care preferences.

Together, these forms and documents provide a comprehensive approach to healthcare planning, ensuring that a person's wishes are respected and that their designated representatives have the authority to act on their behalf. Properly completing and sharing these documents with relevant parties ensures that, no matter the situation, one's healthcare wishes are clearly communicated and can be acted upon without delay.

The Maryland Do Not Resuscitate (DNR) Order form is closely akin to a living will, sometimes known as an advance directive. Both documents are preemptive in nature, designed to communicate a patient's wishes regarding their medical treatment should they become unable to express those wishes themselves. A living will typically outlines a wider range of medical treatments and interventions the patient would like to decline or receive, while a DNR specifically addresses the desire not to receive cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest.

Similarly, a health care proxy, or medical power of attorney, parallels the Maryland DNR in that it delegates decision-making authority regarding medical treatment. The critical distinction lies in their operation: a health care proxy empowers another individual to make health care decisions on the patient’s behalf, covering a broad spectrum of medical decisions beyond the specific intent not to resuscitate expressed in a DNR. This makes the health care proxy a more comprehensive tool for managing one’s medical treatment preferences.

The POLST (Physician Orders for Life-Sustaining Treatment) form is another document that shares a common purpose with the Maryland DNR Order. Like a DNR, a POLST provides specific instructions regarding a patient's preferences for end-of-life care, including interventions such as feeding tubes, antibiotics, and other life-sustaining treatments, in addition to CPR. The difference primarily lies in the scope; while a DNR is specific to not receiving CPR, a POLST covers a broader array of potential interventions.

Finally, the Five Wishes document, although more comprehensive, shares similar intentions with the Maryland DNR Order. It is an advance directive tool that addresses more personal aspects of end-of-life care, including the patient's wishes regarding their comfort, how they want to be treated, what they want loved ones to know, in addition to treatment preferences including resuscitation. The Maryland DNR Order’s focus is narrower, specifically detailing wishes about CPR, but both serve the purpose of guiding medical treatment based on the patient's preferences.

When completing the Maryland Do Not Resuscitate (DNR) Order form, it's crucial to ensure that the process is done accurately and thoughtfully. A DNR form is a sensitive document that requires attention to detail and an understanding of the implications behind the choices it represents. Here is a list of dos and don'ts to consider when filling out the DNR form:

• Do read through the entire form before starting to fill it out to understand all the requirements and sections fully.
• Do consult with a healthcare provider to clarify any medical terms or implications of the DNR order that might not be immediately clear.
• Do ensure that the patient (if capable) or their legally authorized representative is involved in the decision-making process regarding the DNR order.
• Do complete the form with legible handwriting to prevent any misunderstandings or administrative errors.
• Do verify that all required signatures are present on the form, including that of the patient (or representative) and the attending physician.
• Do use black ink for better legibility and to ensure the form is photocopiable without losing clarity.
• Do make multiple copies of the completed DNR form, keeping one with the patient at all times and providing copies to the relevant healthcare professionals.
• Do not rush through filling out the form without adequately considering the medical and emotional implications of a DNR order.
• Do not leave any sections incomplete, as this could lead to the DNR order being considered invalid.
• Do not use correction fluid or tape; if mistakes are made, it's better to start over with a new form to maintain the document's integrity.

Following these guidelines will help ensure that the DNR order reflects the patient's wishes accurately and is executed according to Maryland state law. Always remember that the decision to submit a DNR order is significant and should be made with thorough consideration and professional advice.

Misunderstandings surrounding the Maryland Do Not Resuscitate (DNR) Order form can lead to confusion and distress among patients and their families. By clarifying these misconceptions, individuals can make informed decisions about their end-of-life care preferences. Here are six common misunderstandings about the Maryland DNR Order form:

• Only elderly people need a DNR Order. It's a misconception that DNR Orders are only for the elderly. Individuals of any age with serious health conditions may consider discussing a DNR Order with their physician to ensure that their healthcare wishes are respected.
• Signing a DNR Order means giving up on all medical treatments. This is not accurate. A DNR Order only pertains to not receiving cardiopulmonary resuscitation (CPR) if one's heart stops or if they stop breathing. It does not affect other treatments for comfort, pain relief, or other health issues.
• A DNR Order can only be issued by a physician. While it is true that a DNR Order must be authorized by a licensed healthcare provider, the initiative can come from patients or their healthcare agents. The healthcare provider's role is to ensure that the patient or their designated decision-maker understands the implications of the Order.
• If I change my mind, it's too late to revoke a DNR Order. This is not true. A DNR Order is not permanent and can be revoked at any time by the patient or their authorized health care decision-maker. This can be done through a verbal or written indication that the patient wishes to receive CPR in an emergency, necessitating immediate communication to healthcare professionals.
• Having a DNR Order means you won't be admitted to the hospital. This misunderstanding could cause individuals to hesitate in deciding about a DNR Order. In reality, a DNR Order does not impact decisions regarding hospital admission. It specifically instructs healthcare providers on the non-administration of CPR, but it does not limit other forms of medical intervention that might be necessary.
• A DNR Order is only valid in the hospital. Maryland's DNR Orders are honored both in healthcare facilities and by emergency medical services statewide. It's important for individuals to communicate their DNR status to family and healthcare providers and, when possible, keep the document easily accessible in case emergency services need to be called to the home or another location.

Clarifying these misconceptions can help ensure that individuals' healthcare preferences are honored and respected, fostering a sense of peace during what can be a challenging time for patients and their families.

Filling out the Maryland Do Not Resuscitate (DNR) Order form involves making critical decisions about end-of-life care, indicating one's wish not to have CPR (cardiopulmonary resuscitation) in case their heart stops or they stop breathing. Understanding the implications and procedures surrounding this document is crucial for both patients and their families. Here are key takeaways to guide you through this process:

• It is essential to have an open and thorough discussion with your healthcare provider about your health condition and the implications of a DNR order. This ensures that the decision is made with a clear understanding of the medical realities and respects the individual's wishes.
• The Maryland DNR form requires signature verification. This not only involves the patient's signature but also the healthcare provider's signature. This dual-signature requirement underscores the document's seriousness and ensures that it reflects a mutual decision between the patient and the healthcare provider.
• A legally valid Maryland DNR order must be accessible to emergency personnel. It should be kept in a prominent location where it can be easily found by first responders, such as on the refrigerator or near the patient’s bed. Additionally, patients or their caregivers should consider carrying a portable form, especially when traveling outside the home.
• It's critical to communicate your wishes regarding the DNR order with family members and other loved ones. While it may be a difficult conversation, ensuring that your loved ones understand your preferences can help prevent conflict during emergency situations and ensure that your wishes are respected.

Correctly filling out and effectively using the Maryland DNR Order form is a significant step in planning for end-of-life care. It empowers individuals to make choices that align with their values and wishes, ensuring that they receive the type of care they desire at crucial moments.