Official Do Not Resuscitate Order Template for Maryland

How to Write Maryland Do Not Resuscitate Order

The Maryland Do Not Resuscitate (DNR) Order is a crucial document for individuals wishing to express their desire not to receive cardiopulmonary resuscitation (CPR) in the event their breathing stops or their heart ceases to beat. This document ensures that medical personnel and caregivers respect the patient's wishes regarding end-of-life care. Completing this form requires attention to detail and an understanding of the patient's wishes. Below are the steps necessary to accurately fill out the Maryland DNR Order form, ensuring it is legally binding and reflective of the individual's wishes.

1. Start by gathering all necessary information including the full name of the patient, date of birth, and any relevant medical identification numbers.
2. Ensure the patient or their legally authorized representative is present, as their signature will be required to validate the order.
3. Review the form in its entirety to familiarize yourself with the various sections and what information each requires.
4. Fill in the patient's personal information section with the patient's name, date of birth, address, and any other identification details requested on the form.
5. If applicable, indicate the patient's specific medical conditions or reasons for choosing a DNR order in the appropriate section.
6. Read through the instructions regarding the patient's decision to withhold CPR. This section is critical in ensuring the patient's wishes are clearly stated and understood by all parties.
7. Have the patient or their legal representative carefully review the declaration section that outlines the commitment to the DNR order. Ensure they understand the implications of this decision fully.
8. Complete the signature section by having the patient or their legally authorized representative sign and date the form. This step legally authorizes the DNR order.
9. Obtain the required signatures from the attending physician or authorized healthcare provider. Their signature confirms the medical validity and agreement with the patient's wishes as stated in the DNR order.
10. Ensure copies of the completed DNR order are made and distributed appropriately. A copy should be kept with the patient, one with their primary healthcare provider, and any other caretakers or medical facilities involved in their care.

Completing the Maryland DNR Order form is a process that requires careful consideration and adherence to the steps outlined above. It is a measure that respects the patient's autonomy over their medical care. By following these steps, individuals can ensure their healthcare wishes are known and can be honored in critical situations.

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

A Maryland Do Not Resuscitate (DNR) Order is a legal form signed by both a patient and their healthcare provider. It instructs healthcare workers not to perform cardiopulmonary resuscitation (CPR) if the patient's breathing stops or if the heart stops beating. It's part of an advance directive planning, allowing individuals to make decisions about their end-of-life care ahead of time.

Who can request a DNR Order in Maryland?

Any competent individual over the age of 18 can request a DNR Order in Maryland. This includes those who are diagnosed with a serious illness, facing end of life, or simply wish to avoid CPR in the event of cardiac or respiratory arrest. Minors can also have a DNR Order under specific conditions, which involves consent from a parent or legal guardian.

How does one obtain a DNR Order in Maryland?

To obtain a DNR Order in Maryland, the individual or their legally authorized representative must have a conversation with a healthcare provider about their wishes regarding end-of-life care, specifically about not receiving CPR. This discussion should result in the completion and signing of the DNR Order form. Here are steps to follow:

1. Schedule a discussion with your healthcare provider.
2. Express your wishes regarding CPR and end-of-life care.
3. Complete and sign the DNR Order form with your healthcare provider's assistance.
4. Your healthcare provider will then sign the form, making it official.

What happens if someone changes their mind after signing a DNR Order?

If an individual decides to revoke their DNR Order, they should inform their healthcare provider immediately. The process typically involves:

• Notifying the healthcare provider of their wish to revoke the DNR Order.
• Destroying the original DNR Order form.
• If desired, creating a new advance directive that reflects their current wishes.

Is a Maryland DNR Order valid in other states?

A Maryland DNR Order might not automatically be recognized in other states, as laws and regulations regarding DNR orders can vary. However, most states have procedures in place to respect patients' wishes regarding end-of-life care. It is recommended that individuals carry a copy of their DNR Order when traveling and inform healthcare providers of their DNR status. For extended stays in another state, consider consulting with a local healthcare provider or attorney about the validity of your Maryland DNR Order.

Who should be informed about my DNR Order?

Informing the right people about your DNR Order is critical to ensure that your wishes are respected. Consider sharing this information with:

• Your primary healthcare provider.
• Family members and close friends.
• Any home healthcare providers.
• Hospice care staff, if applicable.
• Carry a copy with you in your wallet or purse.

When filling out the Maryland Do Not Resuscitate (DNR) Order form, it's critical to avoid common mistakes to ensure that the document reflects the individual's wishes accurately and is legally valid. Below are six common mistakes people make on this form.

1. Not verifying the patient's identity accurately. It's vital to ensure that the patient's full name, date of birth, and any other identifying details are correctly entered on the form to prevent any confusion regarding who the DNR Order pertains to.

2. Failing to obtain the necessary signatures. The Maryland DNR Order form requires the signature of the patient (or their authorized representative) and the physician. Missing any of these signatures renders the document invalid.

3. Incomplete information about the patient's decision. The form allows individuals to specify their preferences regarding resuscitation. Leaving these sections blank or incomplete can lead to ambiguity in emergency situations.

4. Using outdated forms. Laws and regulations change, and so do the forms that need to be completed. Using an outdated version of the DNR Order form may result in non-compliance with current Maryland laws.

5. Not discussing the order with family members or healthcare providers. While not strictly a part of filling out the form, failing to communicate the existence and contents of a DNR Order to family members and healthcare providers can cause confusion and distress in an emergency.

6. Omitting to make sufficient copies. Once completed, it's advisable to make several copies of the DNR Order. Keeping a copy readily available at home, and providing copies to healthcare providers and family members ensures that the patient's wishes are known and can be respected.

Avoiding these mistakes helps ensure that the DNR Order accurately reflects the patient’s wishes and will be adhered to by healthcare professionals during critical moments. It's also beneficial to periodically review and update the document as circumstances and preferences may change over time.

In the context of planning for medical emergencies and end-of-life care, individuals often consider a variety of legal documents in addition to a Do Not Resuscitate (DNR) Order. While a DNR specifically addresses the desire not to have cardiopulmonary resuscitation (CPR) performed in the event of a cardiac or respiratory arrest, other documents serve to complement this directive by covering a broader spectrum of decisions regarding healthcare, financial management, and post-mortem arrangements. The following list delineates some of these critical documents, each playing a vital role in a comprehensive approach to personal and legal preparedness.

• Advance Directive: This legal document outlines a person's preferences for medical treatment should they become unable to make decisions for themselves. It often includes a Living Will and a Power of Attorney for healthcare.
• Living Will: A form of Advance Directive, a Living Will specifies what types of life-sustaining treatment an individual wants or does not want if they are terminally ill, permanently unconscious, or in a similar condition.
• Healthcare Power of Attorney: Also part of an Advance Directive, this document appoints someone to make healthcare decisions on behalf of the individual if they become incapacitated.
• Financial Power of Attorney: This document grants a trusted person authority to handle financial affairs in case of incapacity, covering tasks such as paying bills, managing investments, and making other financial decisions.
• LIVING Trust: It allows individuals to place assets in a trust for their benefit during their lifetime, with the remaining assets transferring to designated beneficiaries upon death.
• Will: A legal declaration by which a person, the testator, names one or more persons to manage their estate and provides for the transfer of their property at death.
• POLST (Physician Orders for Life-Sustaining Treatment): A medical order indicating a patient's preferences regarding treatments such as resuscitation, intubation, and use of antibiotics, often used in conjunction with a DNR.
• Organ and Tissue Donation Registration: A form that indicates an individual’s consent to donate their organs and tissues upon death, which can be a separate document or part of a driver's license registration in many states.
• Funeral Planning Declaration: A document that specifies one’s preferences for funeral arrangements, including details on burial or cremation, type of ceremony, and other post-mortem wishes.
• Guardianship Designation: A legal arrangement to appoint a guardian to take care of and make decisions for another person, often used for minors or adults unable to make decisions due to mental incapacitation.

While a Maryland DNR Order form decisively addresses the specific circumstances under which an individual wants to refuse resuscitation, it's merely one component of a broader network of legal instruments designed for thorough medical and personal care planning. The synergistic use of these documents ensures that a person's health care preferences, financial management, and estate plans are respected and executed according to their wishes, providing a sense of security and peace of mind to them and their loved ones. It's essential for individuals to consult with legal and healthcare professionals when drafting these documents to ensure they accurately reflect their wishes and comply with current laws.

The Maryland Do Not Resuscitate (DNR) Order form is similar to several other important healthcare directives, each designed to guide healthcare professionals about a patient's preferences in various medical situations. These documents ensure that an individual's wishes are respected, especially during critical times when they might not be able to communicate their desires themselves. While serving a similar purpose of guiding medical treatment based on patient preferences, these documents differ in scope and application.

Advance Healthcare Directive: The Maryland DNR Order form shares similarities with an Advance Healthcare Directive (AHD), which is a broader legal document. An AHD not only can specify a patient's preference regarding resuscitation but also covers a wide range of other medical decisions, such as the use of ventilators or feeding tubes, and the types of medical treatments they would or would not like to receive in various scenarios. The DNR focuses specifically on the act of resuscitation in the event of cardiac or respiratory failure, whereas an AHD addresses a more comprehensive array of medical interventions and preferences.

Medical Orders for Life-Sustaining Treatment (MOLST): Like the DNR Order, the Medical Orders for Life-Sustaining Treatment form is also used to document a patient's preferences concerning life-sustaining procedures. The MOLST is more detailed than a DNR and applies to patients with serious health conditions, detailing treatments they want to receive or avoid, beyond just CPR. This form can include preferences about intubation, mechanical ventilation, antibiotic use, and artificial nutrition and hydration, making it a critical tool in end-of-life planning.

Living Will: A Living Will is another document related to the Maryland DNR Order, as it also pertains to end-of-life care decisions. However, a Living Will typically comes into play under specific circumstances detailed within the document, such as terminal illness or permanent unconsciousness, and outlines the types of life-prolonging medical treatments an individual does or does not wish to receive. Unlike a DNR, which is strictly focused on not initiating cardiopulmonary resuscitation, a Living Will addresses a broader spectrum of interventions and can include the individual's wishes regarding resuscitation.

When managing a Maryland Do Not Resuscitate (DNR) Order form, it's crucial to handle each step with precision and understanding. This form is pivotal for those wishing to make clear their preferences concerning resuscitation in emergency situations. Below, find key guidelines on what you should and shouldn't do when completing this document.

What You Should Do

1. Verify the patient's eligibility for a DNR order based on Maryland's criteria, ensuring the decision aligns with their health condition and wishes.
2. Have a detailed discussion with the patient or their authorized decision-maker about the implications of a DNR order, ensuring they fully comprehend its scope.
3. Ensure that the form is thoroughly completed, leaving no necessary fields blank, to prevent any ambiguity regarding the patient's wishes.
4. Sign the form in the presence of a witness, where required, to validate the decision. Make sure the witness is someone qualified under Maryland law.
5. Provide accurate and legible contact information for both the patient and the physician, to facilitate clear communication and verification if needed.
6. Securely store a copy of the DNR order in an easily accessible place at the patient's residence, and advise them to inform close family members about its location.
7. Recommend the patient wear a DNR identification bracelet or carry a card, which can quickly inform medical personnel of the DNR status in emergencies.

What You Shouldn't Do

• Do not rush the decision-making process; make sure there is ample time for the patient or their representative to consider all aspects.
• Avoid using technical jargon or complex medical terms when explaining the form to ensure the patient or their representative understands the information clearly.
• Do not witness the form yourself if you are directly involved in the patient’s care, to maintain objectiveness and integrity in the process.
• Never coerce or influence the patient’s decision regarding the DNR order, as it is crucial that their choice is voluntary and informed.
• Refrain from using a photocopy of the form for official records; always submit the original document to ensure compliance with Maryland law.
• Avoid leaving the completed form in obscure or hard-to-reach places where it cannot be found by emergency personnel when needed.
• Do not forget to review and update the DNR order as necessary, especially if the patient's health status or wishes change.

• Only the elderly or those with terminal illnesses can have a Do Not Resuscitate (DNR) order. This is a common misconception. In reality, Maryland allows any competent adult to request a DNR order based on their personal values, beliefs, or specific medical conditions, not just age or terminal illness status.

• A DNR order means no medical intervention will be given in an emergency. This isn't accurate. A DNR specifically refers to not performing cardiopulmonary resuscitation (CPR) if the heart stops or if breathing stops. It does not mean that other life-saving measures, like administering medication or oxygen, will be withheld.

• Having a DNR order means you can’t be hospitalized. This is false. A DNR order does not affect the provision of other medical treatments or hospital admissions. It simply informs healthcare providers of your wishes regarding CPR.

• A DNR order is permanent and cannot be changed once it's in place. Many people believe that once they have a DNR order, it is set in stone. However, in Maryland, as in most places, DNR orders can be revoked or updated at any time based on the person's current wishes or medical condition.

• Only a physician can initiate a DNR order. While it's true that a physician must sign the DNR order for it to be legally valid, the request for a DNR order can come from the patient or their healthcare proxy/advance directive. The doctor then discusses the decision with the patient or their designated decision-maker to ensure it aligns with the patient's wishes and health status.

• The DNR order applies to all medical settings. Actually, in Maryland, there are different types of DNR orders: one is for use in healthcare facilities, and another, the out-of-hospital DNR, is for use outside of these settings. It's important to understand where each type applies and to ensure you have the right documentation for your needs.

• You need an attorney to complete a DNR order. While legal advice can be beneficial in understanding all aspects of end-of-life care planning, including DNR orders, an attorney is not required to complete or file a DNR order in Maryland. These forms are typically discussed and completed with healthcare providers.

• If you have a DNR order, medical professionals will consult your family for final decisions in an emergency. In reality, once a DNR order is in place, it directs medical personnel to follow the wishes documented in the order, regardless of what family members may say in the moment of crisis. This underscores the importance of discussing your wishes with your loved ones before a situation arises.

• Completing a Maryland DNR order is a lengthy and complicated process. Some may be under the impression that the process is cumbersome and time-consuming. However, it primarily involves understanding the form, making informed decisions based on your health care wishes, and discussing these with your doctor or healthcare provider for signature. While it does require thoughtful consideration, the process itself is straightforward.

In Maryland, a Do Not Resuscitate (DNR) Order is a crucial document for individuals who wish to express their preference regarding resuscitation efforts in the event of cardiac or respiratory arrest. Understanding and completing this form accurately ensures your wishes are respected by healthcare providers. Here are seven key takeaways about the Maryland DNR Order form:

• Consult with a healthcare professional: Before completing a DNR form, it is important to discuss your health condition and treatment preferences with a doctor or healthcare provider. This ensures that your decision to opt for a DNR order is informed and reflects your current health status and wishes.
• Signature requirements: The Maryland DNR Order must be signed by the individual (or their legally authorized representative if the individual is incapable) and their physician. The physician's signature certifies that the patient's decision was made voluntarily and with full understanding of the consequences.
• Validity across different settings: The Maryland DNR Order is recognized and honoured in various settings, including hospitals, nursing homes, and by Emergency Medical Services (EMS). Ensure that the completed form is readily accessible in case of an emergency.,
• Keep the form accessible: Once the DNR form is completed and signed, it should be kept in a location where it can be easily found by family members or emergency responders, such as on the refrigerator or in a personal wallet.
• Inform family members and caregivers: It's important to discuss your DNR order with family members and any caregivers to ensure they understand your wishes and know the location of the form. This conversation can help reduce confusion and distress in emergency situations.
• Review and update as necessary: Life circumstances and health preferences can change. Regularly review your DNR order and discuss any desired changes with your healthcare provider. If modifications are necessary, a new form must be completed, signed, and dated.
• Respect for patient autonomy: The Maryland DNR Order is a legal tool that respects an individual's right to make decisions about their own health care, including the choice not to undergo CPR (Cardiopulmonary Resuscitation) or other resuscitative measures. It is an expression of patient autonomy concerning end-of-life care.

Understanding these key aspects of the Maryland DNR Order can help ensure that your healthcare preferences are clearly communicated and honored. Remember, completing a DNR form is a personal decision that should be made after careful consideration and discussion with healthcare professionals and loved ones.