The terms “Do Not Resuscitate Order” and “Living Will” are not the same. Many clients think their advance health care directive functions as a “Do Not Resuscitate Order,” also known as a “DNR.” These documents have some similar provisions, but it is necessary to distinguish the terms.
A DNR is an order written by a physician regarding whether a patient will receive cardiopulmonary resuscitation (“CPR”) if the patient requires resuscitation due to a heart attack or other illness or injury that cases a person’s heart to stop beating and the patient to stop breathing. An out-of-hospital DNR is a document that is signed by a patient’s physician and the patient or their legal representative to emergency medical personnel from administering CPR. The scope of its application is limited: It only applies outside of a hospital and only prevents the administration of CPR.
A Living Will, known in Missouri as a “health care declaration,” is a document directing the withholding or withdrawal of “death prolonging” procedures. This document is created by the patient, not the patient’s physician. It is intended to inform a patient’s health care providers of their end-of-life treatment wishes.
A health care declaration can apply to many more interventions than just the administration of CPR. For example, it can prohibit the use of artificial ventilator support, dialysis, surgery, the administration of antibiotics, artificial nutrition (tube feedings) and hydration (intravenous fluids – IVs), and other invasive medical procedures. The terms of a health care directive will only apply when the patient cannot make or communicate medical decisions.