Homepage Attorney-Verified Louisiana Do Not Resuscitate Order Document
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In the state of Louisiana, individuals have the ability to make critical decisions about their own healthcare, especially when it comes to end-of-life care. One important tool for conveying these decisions is the Louisiana Do Not Resuscitate (DNR) Order form. This legal document communicates a person's wish not to have cardiopulmonary resuscitation (CPR) performed in the event that their breathing stops or their heart ceases to beat. It's a cornerstone for those who, often due to terminal illness or the desire for a natural death free from aggressive medical interventions, choose to decline life-sustaining treatments. Designed to be recognized by doctors, emergency medical technicians, and healthcare facilities, the Louisiana DNR order must be filled out correctly and in compliance with state laws to ensure it is valid. Its prominence in healthcare planning highlights the importance of patient autonomy and the ethical consideration of end-of-life care. By understanding and completing this form, individuals ensure that their healthcare preferences are known and respected, demonstrating the profound dignity and respect accorded to personal choices in the faced of life's most challenging moments.

Form Example

Louisiana Do Not Resuscitate (DNR) Order Template

This document serves as a Do Not Resuscitate (DNR) order, in accordance with the guidelines set forth by the State of Louisiana, specifically under the Louisiana Emergency Medical Services Do Not Resuscitate Order Act. By completing this form, individuals can ensure that no resuscitation efforts will be made in the event of respiratory or cardiac arrest.

Please provide all requested information accurately to ensure the DNR order is processed correctly.









In accordance with Louisiana state law, this DNR order must be signed by the following:

  1. The patient, or their legal representative, if the patient is unable to sign
  2. The patient's attending physician






By signing this Louisiana Do Not Resuscitate Order, all parties acknowledge that they understand the nature and effect of a DNR order, and agree to comply with the patient's wishes as stated herein. This document is legally binding and must be presented to medical personnel when requested.

For more information on DNR orders in Louisiana, or if you have any questions about completing this form, please consult your healthcare provider or seek legal advice.

PDF Characteristics

Fact Detail
Governing Law Louisiana Revised Statutes, specifically title 40:1299.58.6 concerning Do Not Resuscitate orders
Purpose To inform medical personnel not to perform CPR (cardiopulmonary resuscitation) on the person holding the DNR order in case of cardiac or respiratory arrest
Who Can Request Any adult with the capacity to make healthcare decisions, or a legal guardian/healthcare proxy of an individual unable to make medical decisions
How to Obtain Must be issued by a Louisiana licensed physician after discussion with the patient or the patient's legal representative
Form Requirement The DNR order should be on a specific state-provided form or written as a doctor’s order within the medical records in compliance with state regulations
Where to Keep The form or order should be kept in a place where it is easily accessible to emergency personnel, such as in the home in a visible location or as part of medical records
Revocation The individual or their legal representative has the right to revoke the DNR order at any time, through verbal or written communication to healthcare providers

Instructions on Filling in Louisiana Do Not Resuscitate Order

Filling out the Louisiana Do Not Resuscitate (DNR) Order form is a step taken when an individual decides not to receive cardiopulmonary resuscitation (CPR) in the event their breathing stops or heart ceases to beat. This document is critical as it communicates the individual's wishes to medical professionals during emergency situations. Completing this form accurately ensures that these wishes are known and can be acted upon accordingly. Here, you are guided through the required steps to fill out the form, ensuring the document is legally binding and reflecting the individual's explicit instructions.

  1. Begin by clearly printing the full legal name of the individual the DNR order is for. This ensures there is no confusion regarding whom the DNR applies to.
  2. Next, include the date of birth of the individual to further identify them and to avoid any potential mix-ups with another patient.
  3. Fill in the address of the individual. This information is critical in ensuring that emergency responders are aware that they are treating the correct person, especially in cases where the DNR order needs to be quickly verified.
  4. Enter the specific medical conditions that justify the DNR order. This section provides vital context for the medical decision not to resuscitate.
  5. Specify the effective date of the DNR order. This is the date from which the order should be recognized and applied in any medical situation.
  6. Ensure the individual or their legally authorized representative signs the form. This signature is required to validate the individual's wishes formally.
  7. The signature of the physician is also required as a confirmation that the DNR order has been discussed with the individual (or their representative) and that the doctor agrees it is in the individual's best interest.
  8. Finally, print the name and address of the witnessing healthcare provider or notary public. This acts as an additional layer of verification for the DNR order's legitimacy and compliance with Louisiana's legal requirements.

Once the form is completed and properly signed, it is essential to keep it in an easily accessible location. This ensures that in an emergency, the form can be quickly found by family members or medical personnel, thereby respecting the individual's health care wishes. Additionally, consider informing close family members, caregivers, and primary healthcare providers about the DNR order's existence and location.

Listed Questions and Answers

What is a Louisiana Do Not Resuscitate Order form (DNR)?

A Louisiana Do Not Resuscitate Order form, commonly known as a DNR, is a legal document instructing medical professionals not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. It is used by individuals who wish to avoid life-extending measures in cases of serious illness or terminal conditions.

Who can request a DNR in Louisiana?

In Louisiana, the following individuals can request a DNR order:

  • The patient themselves, if they are of sound mind and 18 years of age or older.
  • A legal guardian or someone holding a durable power of attorney for healthcare decisions, if the patient is unable to make medical decisions on their own.
  • Parents or legal guardians, in the case of a minor.

How can one obtain a Louisiana DNR form?

Obtaining a Louisiana DNR form typically involves:

  1. Discussing end-of-life wishes with a healthcare provider. A physician can provide guidance and the DNR form itself.
  2. Completing the form as per Louisiana state regulations, which includes signatures from the patient (or their representative) and the physician.
  3. Filing the completed form with the patient's medical records and informing family members or caretakers of the decision.

Is a DNR order permanent?

No, a DNR order is not permanent. A patient or their authorized representative has the right to cancel or revise the order at any time. This decision should be communicated to the healthcare provider as soon as possible to ensure the patient's medical records are updated accordingly.

What happens if emergency services are called?

If emergency services are called, it is crucial to inform them immediately that a DNR order exists. Ideally, the DNR form should be kept in an easily accessible location, and a copy should be given to the emergency personnel upon their arrival. Emergency services are required to follow the instructions on a DNR order when they are made aware of its existence.

Does a DNR order affect other forms of medical treatment?

No, a DNR order specifically addresses the issue of cardiopulmonary resuscitation and does not impact other forms of medical treatment. Patients with a DNR order can still receive medication, nourishment, oxygen, and other forms of care intended to relieve pain and provide comfort.

Common mistakes

Filling out a Louisiana Do Not Resuscitate (DNR) Order form is a crucial process for those who wish to communicate their wishes regarding life-sustaining treatments in dire health situations. However, mistakes can happen, affecting the efficacy of the document. Below are common errors people make:

  1. Not verifying the patient's full and legal name is correctly spelled. A DNR order must accurately identify the individual it concerns.

  2. Omitting the date of birth or entering it incorrectly. This is vital for verifying the patient's identity.

  3. Failing to discuss the decision with healthcare providers. It's important for medical professionals to understand the patient's wishes clearly and to ensure the form is filled out correctly.

  4. Not obtaining the required signatures. Both the patient (or their legal representative) and the physician must sign the DNR order for it to be valid.

  5. Using an unofficial form or not following the state's specific requirements can lead to the DNR order not being recognized by healthcare providers.

  6. Not specifying the patient's medical condition if required. This can help in clarifying the context under which the DNR order should be applied.

  7. Forgetting to renew or update the DNR order. Like many legal documents, a DNR order may need to be renewed or updated based on state laws or as the patient's wishes change.

  8. Not communicating the existence of the DNR order to family members or those who may need to know. This oversight can lead to confusion and distress during critical moments.

  9. Not having the form accessible. A DNR order needs to be readily available to healthcare providers in an emergency.

  10. Misunderstanding the form's scope, such as believing it covers more or less than it actually does. A DNR order specifically addresses the use of CPR and does not apply to other treatments or care.

It's essential to approach filling out a DNR order with attention and care, ensuring all information is accurate and reflective of the patient's wishes. Considering the gravity of what a DNR order represents, avoiding these common mistakes can help ensure that a patient's preferences are respected during critical health events.

Documents used along the form

A Do Not Resuscitate (DNR) Order is a crucial document in Louisiana, expressing an individual's choice not to receive CPR or other life-saving measures in the event of cardiac or respiratory arrest. However, it's often just one piece of a comprehensive healthcare directive puzzle. To ensure one's healthcare wishes are fully understood and respected, several other documents are typically used alongside a Louisiana DNR Order. Here's a brief overview of the most common forms and documents that complement a DNR Order in Louisiana.

  • Advance Directive/Living Will: This document allows individuals to outline their healthcare preferences, including end-of-life care and decisions about life-sustaining treatments, in scenarios other than those specifically outlined in a DNR Order.
  • Healthcare Power of Attorney (HCPA): A legal document that designates another person (known as an agent) to make healthcare decisions on an individual's behalf if they become unable to do so.
  • Physician Orders for Scope of Treatment (POST): Similar to a DNR, this form goes further to specify preferences for other types of life-sustaining treatments, such as antibiotics, tube feeding, and intensive care.
  • Medical Orders for Life-Sustaining Treatment (MOLST): This is a medical order that outlines a person's preferences for life-sustaining treatments, including CPR, ventilation, and artificial nutrition.
  • Organ and Tissue Donation Registration: A form that records an individual's consent to donate their organs and tissues upon death.
  • Hospital Patient Registration Form: Completed upon admission to a hospital, this form includes vital information and can indicate that a DNR Order is in place.
  • Emergency Contact Information: A document listing the names, relationships, and contact details of people who should be notified in an emergency.
  • Medical Information Card: A compact card that contains critical health information, including the existence of a DNR Order, allergies, medications, and conditions, which can be invaluable in an emergency.
  • Living Trust: A legal arrangement where one's assets are placed into a trust for their benefit during their lifetime and then transferred to designated beneficiaries upon death. It can include instructions regarding healthcare decisions.

Together, these documents provide a comprehensive framework that respects and protects an individual's healthcare wishes throughout different medical circumstances. Each plays a unique role in ensuring that one's healthcare preferences are understood, respected, and followed by healthcare providers and loved ones alike. Having these forms in order can bring peace of mind to individuals and their families, knowing that their healthcare wishes will be honored.

Similar forms

The Louisiana Do Not Resuscitate (DNR) Order form is similar to other advanced healthcare directives in its purpose, which is to instruct healthcare professionals on the care an individual wishes to receive or not receive in the event they are unable to communicate those wishes themselves. Unlike a Last Will and Testament, which is used to handle affairs after death, a DNR specifically addresses the types of life-sustaining treatments a person wants to avoid.

Living Will: The Living Will is closely related to a DNR order but is more comprehensive in scope. While a DNR strictly instructs healthcare providers not to perform CPR or other life-sustaining procedures if a person's heart stops or if they stop breathing, a Living Will can provide directives on a broader range of treatments. This can include mechanical ventilation, tube feeding, dialysis, and other interventions. Essentially, a Living Will details what kinds of life support measures a person does or does not want if they are in a terminal condition or permanently unconscious, offering a broader directive than a DNR.

Healthcare Power of Attorney: Another document similar to a DNR order is the Healthcare Power of Attorney (HCPOA). Unlike a DNR, which explicitly expresses the wish not to undergo certain life-saving procedures, an HCPOA designates another individual to make healthcare decisions on one's behalf. This appointed agent makes decisions based on the person's known wishes, which could encompass accepting or refusing life-sustaining treatment, including the directives that might be found in a DNR. The key difference is in the scope of decision-making power, which is broader in an HCPOA and includes the ability to adapt to situations that might not have been anticipated when the directive was written.

Advance Directive: An Advance Directive is a broader term that can encompass both a Living Will and a DNR order, among other directives. It's a document, or sometimes a set of documents, that outlines a person's wishes regarding medical treatment and care if they become unable to communicate those wishes themselves. Within an Advance Directive, someone can include a DNR order as part of their instructions for end-of-life care, along with specifications from a Living Will about which life-sustaining treatments they do or do not want. Thus, an Advance Directive provides a comprehensive approach to planning for medical care, incorporating the specific intents of a DNR within a wider context of healthcare preferences.

Dos and Don'ts

Filling out the Louisiana Do Not Resuscitate (DNR) Order form requires careful attention to ensure your health care wishes are clearly documented and legally recognized. Here’s a list of things you should and shouldn't do to guide you through the process.

Things You Should Do

  1. Read the form carefully to understand what signing a DNR order means for your health care decisions.

  2. Discuss your decision with your family, loved ones, and health care providers to make sure they understand your wishes.

  3. Ensure all required sections of the form are filled out correctly, including full legal names, dates, and signatures.

  4. Keep the original form in an easily accessible place and provide copies to your health care proxy, family members, or anyone else involved in your health care decisions.

Things You Shouldn't Do

  1. Don't fill out the form without fully understanding the implications of a DNR order. If you have questions, it’s important to seek clarification from a medical professional.

  2. Don't leave any sections of the form incomplete. This could make the DNR order invalid or lead to confusion about your wishes.

  3. Don't use informal nicknames or abbreviations for names or important medical terms. Always use full, legal names and clear, medical language.

  4. Don't forget to update your DNR order if your health care preferences or personal information changes. Keeping the document up to date ensures that your wishes are accurately reflected.

Misconceptions

Discussing a Do Not Resuscitate (DNR) order often brings with it a set of misconceptions, especially when it comes to the specific requirements and implications within the state of Louisiana. It’s crucial to understand what a DNR order entails to ensure that healthcare decisions align with one's wishes. Below, we debunk some common misunderstandings about the Louisiana Do Not Resuscitate Order form.

  • Misconception 1: A verbal request is enough for a DNR order. In Louisiana, a DNR order must be documented formally. Verbal wishes alone are not sufficient to halt resuscitation efforts.
  • Misconception 2: Only the elderly or terminally ill can have a DNR order. Individuals of any age and health status can request a DNR order, provided they understand the implications and it is appropriately documented.
  • Misconception 3: A DNR order means no medical treatment. This is a common misunderstanding. A DNR order specifically refers to not performing CPR or advanced cardiac life support in the event of cardiac or respiratory arrest. It does not mean that other forms of medical care, including pain relief and comfort care, will be withheld.
  • Misconception 4: A DNR order is permanent. A person or their authorized healthcare proxy can rescind a DNR order at any time if they change their mind. It's essential to communicate any changes to healthcare providers promptly.
  • Misconception 5: All states recognize Louisiana’s DNR orders. While many states have reciprocity regarding DNR orders, it’s crucial to check the specific laws in each state. Traveling individuals should be aware of how their DNR orders are viewed outside Louisiana.
  • Misconception 6: DNR orders only apply in healthcare facilities. In Louisiana, DNR orders can also apply to out-of-hospital scenarios. It’s important for individuals and their families to understand the settings in which their DNR order is effective.
  • Misconception 7: You need a lawyer to complete a DNR order. While legal advice might be beneficial, especially in complex situations, a lawyer is not required to complete a DNR order in Louisiana. Health care providers can guide you through the process.
  • Misconception 8: DNR orders are ignored in emergencies. Emergency responders and healthcare providers in Louisiana are trained to look for and respect DNR orders. It's vital, however, for these documents to be easily accessible and identifiable in an emergency situation.
  • Misconception 9: A DNR order affects insurance coverage. Choosing to have a DNR order should not impact health insurance coverage. It's a personal healthcare decision and unrelated to insurance policies.
  • Misconception 10: Family consent is required for a DNR order. While it's often beneficial to discuss healthcare decisions with family members, an adult with decision-making capacity does not need family consent to enact a DNR order in Louisiana.

Dispelling these myths is crucial in understanding the true nature and scope of DNR orders. Individuals in Louisiana considering a DNR should discuss their wishes with healthcare providers to ensure that their healthcare directives are accurately documented and respected.

Key takeaways

Understanding the Louisiana Do Not Resuscitate (DNR) Order form is crucial for ensuring one's medical wishes are respected. Here are key takeaways to be aware of when dealing with this document:

  • A Louisiana DNR Order is a legal document that tells healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if a person's heart stops or if they stop breathing.
  • The form must be filled out by a licensed healthcare provider in Louisiana, based on the wishes expressed by the patient or their legal healthcare decision-maker.
  • To be valid, the DNR Order must include the patient’s full name, date of birth, and other identifying information, ensuring that the document is easily associated with the right individual.
  • It is essential for the form to be signed by both the patient (or their legal representative) and the healthcare provider to acknowledge the mutual agreement on the DNR status.
  • The DNR Order should be kept in a place where it is readily accessible to emergency medical personnel. A common suggestion is to keep it near the patient’s bed or on the refrigerator door.
  • Patients or their representatives need to inform family members and caregivers about the existence and location of the DNR Order to prevent any confusion during an emergency.
  • Wearing DNR identification, such as bracelets or necklaces, can also help to quickly communicate a person’s DNR status to medical personnel during an emergency.
  • The DNR Order can be revoked at any time by the patient or their legal representative. This should be done in writing, and all parties who had a copy of the DNR Order should be informed.
  • It's important to review and potentially update the DNR Order periodically, especially if the patient’s health status or wishes change.
  • Understanding local laws and hospital policies related to DNR Orders in Louisiana is recommended, as these can impact the implementation of the patient's wishes.

Having comprehensive knowledge about the Louisiana DNR Order process ensures that individuals can make informed decisions about their end-of-life care and have their wishes respected.

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