Attorney-Verified  Do Not Resuscitate Order Form for Oregon

Attorney-Verified Do Not Resuscitate Order Form for Oregon

The Oregon Do Not Resuscitate (DNR) Order form allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. This critical document is essential for ensuring that healthcare providers respect a person's preferences when it comes to life-sustaining measures. If you or a loved one are considering this option, please take the next step by filling out the form below.

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Content Overview

The Oregon Do Not Resuscitate Order form is a key document for individuals who wish to clearly express their preferences regarding medical interventions in the event of a life-threatening situation. Designed to provide clarity and legal backing, this form allows patients to specify that they do not want to receive cardiopulmonary resuscitation (CPR) or other resuscitative measures when their heart or breathing stops. In addition to serving as a personalized directive, it comes with vital requirements for legitimacy, including the need for patient or surrogate signing and medical provider endorsement. The form should also be readily accessible to emergency medical personnel to ensure that an individual's wishes are honored promptly. Moreover, it's important to understand how the form interacts with broader advance care planning, and how it can be revoked or altered to adapt to changes in one’s health status or preferences. Recognizing the emotional weight of this decision, the Oregon Do Not Resuscitate Order form stands as an essential tool in empowering individuals to maintain control over their medical care, providing peace of mind during uncertain times.

Oregon Do Not Resuscitate Order Sample

Oregon Do Not Resuscitate Order

This Do Not Resuscitate Order (DNR) is made in accordance with Oregon state law to direct healthcare providers not to perform resuscitation efforts. This order applies in situations where the individual has a terminal condition and wishes to avoid resuscitation.

Patient Information:

  • Name: ____________________________
  • Date of Birth: ____________________________
  • Address: ____________________________

Ordering Physician Information:

  • Name: ____________________________
  • License Number: ____________________________
  • Contact Information: ____________________________

Effective Date: ____________________________

This DNR order is valid until revoked or modified by the patient or the patient's legal representative. By signing this DNR, the patient confirms that they understand the implications and wishes for no resuscitation efforts in the event of a cardiac arrest or respiratory failure.

Signatures:

  • Patient Signature: ____________________________
  • Date: ____________________________
  • Legal Representative Signature (if applicable): ____________________________
  • Date: ____________________________

This document must be honored by all medical personnel in the state of Oregon. Ensure copies are provided to relevant healthcare providers and kept in accessible locations.

PDF Specifications

Fact Name Description
Definition An Oregon Do Not Resuscitate (DNR) order is a legal document that informs medical personnel not to perform cardiopulmonary resuscitation (CPR) if a patient’s heart or breathing stops.
Laws Governing DNR The Oregon DNR order is governed by Oregon Revised Statutes § 127.660 to § 127.685, which outlines the legal framework for advance directives.
Eligibility Any adult who is competent can complete a DNR order. It is generally recommended that individuals with terminal illnesses or serious health conditions consider this option.
Signature Requirements The DNR form must be signed by the patient or a legally authorized representative. The signature of a witness is also necessary for verification.
Informed Consent Patients must be fully informed of the consequences of their DNR order. This includes understanding the implications for their medical care.
Implementation Once completed and signed, the DNR order is valid and should be prominently displayed in the patient’s medical record to ensure that healthcare providers follow the directive.
Revocation The DNR order can be revoked at any time by the patient. This can be done verbally or in writing, and healthcare providers must respect this change.
Additional Resources Oregon Health Authority provides resources and guidance on completing a DNR order, helping patients make informed decisions about their end-of-life care.

Oregon Do Not Resuscitate Order: Usage Instruction

Completing the Oregon Do Not Resuscitate Order form is a personal decision that requires careful consideration. Following the steps below will help ensure that the form is filled out correctly. Once completed, the form should be discussed with your healthcare provider and placed in a location that is easily accessible to first responders.

  1. Download the Oregon Do Not Resuscitate Order form from an authorized source.
  2. Begin by filling in your full name and date of birth at the top of the form.
  3. Provide your primary contact information, including your address and phone number.
  4. Designate a healthcare representative, if desired, by listing their name and contact information.
  5. Clearly state your preferences regarding resuscitation in the designated section.
  6. Sign and date the form at the bottom. Be sure to have a witness present if required.
  7. Make copies of the completed form for your records and for your healthcare representative.
  8. Distribute copies of the form to your healthcare provider and keep a copy in an easily accessible location.

Frequently Asked Questions

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

    A Do Not Resuscitate Order is a medical order that indicates a person's wishes regarding resuscitation efforts in case of cardiac arrest or respiratory failure. In Oregon, this order allows a person to decline CPR and other life-sustaining treatments in specific medical situations.

  2. Who can complete a DNR Order in Oregon?

    In Oregon, a DNR Order can be completed by individuals who have the capacity to make decisions about their medical care. This usually includes adults and emancipated minors. Additionally, a legal representative may assist someone who cannot express their wishes due to medical incapacity.

  3. How do I obtain a DNR Order form in Oregon?

    You can obtain a DNR Order form through several sources, including healthcare providers, hospitals, and state health department websites. It is crucial to ensure you are using the most current version of the form.

  4. What information is required on the DNR Order form?

    The DNR Order form typically requires information about the patient's identity, medical conditions, and the signature of a physician along with the patient's signature. This confirms that both the patient and their healthcare provider agree to the terms of the order.

  5. How is the DNR Order recognized in a medical setting?

    A properly completed DNR Order is legally recognized in Oregon. Healthcare providers are required to respect the wishes expressed in the order. It is recommended that individuals carry a copy of the DNR Order with them or display it prominently in their homes for easy access during medical emergencies.

  6. Can a DNR Order be revoked or changed?

    Yes, a DNR Order can be revoked or changed at any time by the individual who issued it. This can be done verbally or in writing. It is important to inform healthcare providers of any changes to ensure that your current wishes are followed.

  7. Will having a DNR Order affect other types of medical treatment?

    Having a DNR Order specifically relates to resuscitation efforts. It does not impact other medical treatments. Patients can still receive necessary care for their medical conditions and illnesses, even if they choose not to be resuscitated in an emergency situation.

Common mistakes

Filling out the Oregon Do Not Resuscitate Order (DNR) form is an important decision for individuals who wish to express their healthcare preferences at the end of life. However, mistakes can often occur during this process that may affect the effectiveness of the order. Understanding these common errors can help ensure that the form is completed correctly and aligns with the individual's wishes.

One common mistake is failing to sign and date the form appropriately. Both the patient and the attending physician must sign the DNR order for it to be considered valid. Without these signatures, the form may not be recognized by medical personnel during a critical moment. It's crucial to pay attention to these details to prevent complications in honoring a patient's wishes.

Another frequent error involves not providing clear identification. The form must contain the patient's name, date of birth, and other identifying information. Omitting any of these details can lead to confusion, especially in emergency situations. Ensuring that this information is accurate and complete helps prevent any misunderstandings about who the DNR order is intended for.

Sometimes, individuals may overlook the importance of discussing their decisions with their healthcare provider. It’s essential to have a conversation about the DNR order before completing the form. The healthcare team can offer insights into how the order aligns with the individual's medical condition and treatment options. This discussion can help ensure that the form accurately reflects the patient's wishes.

Lastly, many people forget to review and update the form as health conditions change. A DNR order should reflect a person’s current wishes and medical situation. Life circumstances can evolve, and it may be necessary to revise the DNR to ensure it remains a true representation of a person's intent. Regular review can help assure that the order continues to convey the right preferences.

Documents used along the form

When considering a Do Not Resuscitate (DNR) Order in Oregon, several complementary documents can enhance the clarity of medical preferences and ensure that one's wishes are honored. Each of these documents serves a unique purpose in managing healthcare decisions.

  • Advance Directive: This legal document outlines an individual's preferences regarding medical treatment and end-of-life care. It allows for the appointment of a healthcare representative and specifies which treatments should or should not be administered under different circumstances.
  • Durable Power of Attorney for Health Care: This document designates someone to make healthcare decisions on behalf of an individual if they are unable to communicate their wishes. It empowers the appointed person to act in the best interest of the individual according to their stated preferences.
  • POLST (Physician Orders for Life-Sustaining Treatment): A POLST form is a medical order that reflects a patient’s preferences regarding lifesaving treatments. Unlike DNR orders, POLSTs provide specific instructions for healthcare providers in emergency situations and across a range of treatments.
  • Healthcare Proxy Form: Similar to the durable power of attorney, a healthcare proxy authorizes someone to make medical decisions for an individual when they cannot do so. This form is vital for ensuring that someone familiar with the person’s values and desires is making choices on their behalf.
  • Living Will: A living will expresses an individual's wishes regarding medical treatment in situations where they cannot express their preferences. It typically includes directions regarding life-sustaining measures and other interventions in terminal states.
  • Medication Administration Record (MAR): This document is used by healthcare providers to track and manage medications prescribed to patients. While not always directly connected to end-of-life decisions, it plays a role in ensuring that all medical care aligns with a patient's wishes as outlined in other documents.

Incorporating these documents alongside the DNR Order can provide a comprehensive approach to healthcare decisions, ensuring that individuals’ wishes are respected and followed during critical moments. It is always beneficial to discuss these choices with family members and healthcare providers, fostering an understanding of and respect for personal preferences.

Similar forms

  • Living Will: This document outlines your preferences for medical treatment in situations where you may be unable to communicate your wishes. Like a DNR, it ensures that your choices are respected.
  • Durable Power of Attorney for Healthcare: This form allows you to designate someone to make medical decisions on your behalf. It complements the DNR by designating an advocate for your healthcare choices.
  • Advance Healthcare Directive: It combines elements of a living will and a durable power of attorney, specifying treatment preferences and designating a decision-maker.
  • Physician Orders for Life-Sustaining Treatment (POLST): This document translates your end-of-life treatment preferences into actionable medical orders, similar to a DNR, but more comprehensive.
  • Healthcare Proxy: Much like a durable power of attorney, this document appoints someone to make healthcare decisions when you are unable to do so yourself. It provides clarity in line with your DNR intentions.
  • Do Not Hospitalize (DNH) Order: This form specifically instructs healthcare providers not to admit you to a hospital under certain conditions, which can work in tandem with a DNR.
  • Out-of-Hospital Do Not Resuscitate Order: Similar to a DNR, but specifically applicable outside of hospital settings, this document ensures your wishes are upheld in emergencies.
  • End-of-Life Care Plan: This comprehensive plan covers various aspects of medical and personal preferences as you approach the end of life, complementing the DNR by providing context to your wishes.
  • Patient Self-Determination Act (PSDA) Documentation: While not a specific document, this act assures that patients are informed of their rights to make decisions about their care, aligning with the intent behind a DNR.
  • Preference for Medical Treatment: Often found in various advance planning documents, this outlines your specific preferences, ensuring consistency with a DNR in terms of desired interventions.

Dos and Don'ts

When filling out the Oregon Do Not Resuscitate Order form, it’s important to follow guidelines to ensure the document is valid and reflects your wishes. Here are ten things to consider:

  • Do: Read the instructions carefully before starting.
  • Do: Provide complete and accurate information.
  • Do: Discuss your wishes with your healthcare provider.
  • Do: Ensure your signature is present on the form.
  • Do: Keep copies of the completed form in accessible locations.
  • Don't: Rush through the form; take your time to answer each section.
  • Don't: Use vague language or terms that may be open to interpretation.
  • Don't: Forget to date the form when you sign it.
  • Don't: Ignore state requirements for the form to be valid.
  • Don't: Leave blank spaces; fill out all fields unless instructed otherwise.

Following these guidelines will help ensure your Do Not Resuscitate Order accurately represents your wishes and is legally binding.

Misconceptions

Many people have misunderstandings about the Oregon Do Not Resuscitate (DNR) Order form. Here are some common misconceptions clarified:

  • DNR means no medical treatment at all. A DNR order specifically refers to the refusal of resuscitative measures, such as CPR, in the event of cardiac arrest. Other treatments and interventions, including medications or comfort care, can still be provided.
  • DNR orders are only for terminally ill patients. While many individuals with terminal conditions may choose a DNR, it can be appropriate for anyone who does not wish to undergo resuscitation, regardless of their overall health status.
  • A DNR is the same as a living will. A DNR order specifically addresses resuscitation preferences. A living will, on the other hand, outlines broader decisions about medical treatment preferences in various situations.
  • You cannot change your mind about a DNR order. Individuals can revise or revoke their DNR orders at any time, as long as they have the capacity to do so. Communication with healthcare providers is essential for updating these preferences.
  • Only doctors can issue a DNR order. While healthcare providers often assist with the process, patients, or their legal representatives can initiate a DNR order after discussing their wishes with a physician.
  • A DNR order is permanent and has no expiration. In Oregon, DNR forms do not last indefinitely. They can expire or become invalid under certain conditions, such as if the patient is transferred to a different facility or if their medical condition changes significantly.
  • Once a DNR is signed, it is always honored. A DNR order should be honored as long as it is valid. However, in a hospital setting and for certain emergency situations, medical personnel may initially perform resuscitation until they confirm the presence of a valid DNR order.
  • Having a DNR means you will receive poor care. A DNR order does not indicate a lack of care. Individuals with a DNR will still receive appropriate medical treatment and palliative care to ensure comfort and quality of life.
  • A DNR order can be easily lost or misplaced. To avoid confusion, it is crucial to keep the DNR form accessible and inform family members and healthcare agents of its existence. Medical facilities should also have a process in place to recognize and respect the order.

Understanding these points ensures that individuals can make informed decisions about their healthcare preferences. Open conversations with healthcare providers and loved ones help clarify wishes regarding resuscitation and end-of-life care.

Key takeaways

  • The Oregon Do Not Resuscitate Order form is designed for individuals who do not wish to receive CPR in the event of a cardiac arrest.
  • Patients must have the capacity to make healthcare decisions when filling out the form.
  • The form requires a physician's signature to validate the request.
  • It is important to have a clear understanding of the implications of choosing a Do Not Resuscitate Order.
  • Once completed, the form should be kept in a place that is easily accessible to emergency medical personnel.
  • Patients are encouraged to discuss their decision with family members and healthcare providers.
  • The form is recognized statewide, ensuring that your wishes are respected across different healthcare settings.
  • Revisions to the form can be made if a patient's wishes change over time.
  • An advance directive may complement the Do Not Resuscitate Order by outlining additional healthcare preferences.

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