Printable Oregon Do Not Resuscitate Order Document
Content Overview
The Oregon Do Not Resuscitate (DNR) Order form serves as a critical tool for individuals wishing to express their preferences regarding medical interventions in emergency situations. This legally binding document allows patients to refuse cardiopulmonary resuscitation (CPR) and other life-saving measures in the event of a cardiac or respiratory arrest. It is designed for use by adults who are facing serious health challenges, or who wish to ensure that their end-of-life wishes are respected. The form must be completed and signed by a qualified health care provider, and it requires the patient's signature or that of a legally authorized representative. Once executed, the DNR order should be readily accessible to emergency medical personnel and included in the patient's medical records. Understanding the implications of this form is essential for patients, families, and healthcare providers alike, as it addresses sensitive issues surrounding autonomy, quality of life, and the right to make informed decisions about one's own healthcare. In Oregon, the DNR order also aligns with broader discussions about advance care planning and the importance of having open conversations about end-of-life care preferences.
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Living Will: A living will outlines a person's preferences regarding medical treatment in situations where they are unable to communicate their wishes. Like a Do Not Resuscitate Order, it provides guidance to healthcare providers about the types of interventions a patient desires or does not desire at the end of life.
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Durable Power of Attorney for Healthcare: This document designates an individual to make medical decisions on behalf of someone else if they become incapacitated. Similar to a DNR, it ensures that a person's healthcare preferences are respected, as the appointed agent can advocate for the patient's wishes regarding resuscitation and other critical treatments.
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Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that details a patient's preferences for life-sustaining treatments, including resuscitation. It is similar to a DNR in that it communicates a patient’s wishes to emergency responders and healthcare providers, ensuring that their treatment preferences are honored.
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Advance Healthcare Directive: This comprehensive document combines elements of a living will and a durable power of attorney for healthcare. It allows individuals to specify their medical treatment preferences and appoint someone to make decisions on their behalf, much like a DNR, ensuring that their choices regarding resuscitation and other medical interventions are clear and respected.
Preview - Oregon Do Not Resuscitate Order Form
Oregon Do Not Resuscitate Order
This Do Not Resuscitate (DNR) Order is a legal form, governed by Oregon state laws regarding advance directives. This document grants specific instructions regarding resuscitation measures in the event of cardiac or respiratory arrest.
It is crucial to fill out the following sections accurately to ensure your healthcare wishes are respected.
Patient Information:
- Patient's Name: _______________
- Date of Birth: _______________
- Patient's Address: _______________
- Patient's Phone Number: _______________
Health Care Representative (if applicable):
- Name: _______________
- Phone Number: _______________
Order Statement:
I, the undersigned, am requesting that in the event of a cardiac or respiratory arrest, no resuscitative measures be initiated. This decision has been made freely and without coercion. I understand the implications of this directive.
Signature: _______________
Date: _______________
Witness Information:
- Witness Name: _______________
- Date: _______________
Please keep a copy of this document in a safe place and consider providing copies to your healthcare provider, family members, and anyone else who may need to be aware of your wishes.
Key takeaways
Filling out and using the Oregon Do Not Resuscitate (DNR) Order form is an important process for individuals who wish to express their preferences regarding medical treatment in emergency situations. Here are some key takeaways to consider:
- The DNR Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest.
- It is essential for individuals to discuss their wishes with family members and healthcare providers before completing the form.
- The DNR Order must be signed by a physician, nurse practitioner, or physician's assistant to be valid.
- Individuals can request a DNR Order if they have a serious illness or are nearing the end of life.
- The form should be kept in an easily accessible location, such as on the refrigerator or with other important medical documents.
- It is advisable to carry a copy of the DNR Order when traveling or when receiving care outside of a hospital setting.
- The DNR Order can be revoked at any time by the individual or their legal representative.
- Emergency medical personnel are trained to recognize and respect the DNR Order, provided it is properly completed and signed.
- In Oregon, the DNR Order is recognized statewide, ensuring that individuals' wishes are honored regardless of where they receive care.
- It is beneficial to review and update the DNR Order regularly, especially if there are changes in health status or personal preferences.
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PDF Overview
| Fact Name | Description |
|---|---|
| Purpose | The Oregon Do Not Resuscitate Order (DNR) form allows individuals to refuse resuscitation in case of cardiac or respiratory arrest. |
| Governing Law | This form is governed by Oregon Revised Statutes (ORS) 127.505 to 127.660, which outline the legal framework for advance directives. |
| Eligibility | Any adult can complete a DNR order, but it must be signed by a physician to be valid. |
| Signature Requirement | The form must be signed by the patient or their legal representative, along with the physician's signature. |
| Location | It is recommended to keep the DNR order in a visible location, such as on the refrigerator or with other important documents. |
| Revocation | A DNR order can be revoked at any time by the patient or their representative, verbally or in writing. |
| Emergency Medical Services | Emergency medical personnel must honor the DNR order, provided it is properly completed and signed. |
| Additional Considerations | Patients are encouraged to discuss their wishes with family and healthcare providers to ensure understanding and compliance. |
Documents used along the form
When considering end-of-life care options in Oregon, it’s important to understand various forms and documents that work alongside the Do Not Resuscitate (DNR) Order. Each of these documents serves a specific purpose, ensuring that an individual's wishes are respected and that healthcare providers have clear guidance on how to proceed in medical emergencies.
- Advance Directive: This document allows individuals to outline their preferences for medical treatment and appoint a healthcare representative to make decisions on their behalf if they become unable to communicate.
- Living Will: A type of advance directive, a living will specifies the types of medical treatments an individual wishes to receive or avoid in the event of a terminal illness or incapacitation.
- Promissory Note: A Pennsylvania Promissory Note is a legal document in which one party promises to pay a specified sum of money to another party at a designated time. For more information, visit promissoryform.com/blank-pennsylvania-promissory-note.
- Healthcare Power of Attorney: This legal document designates a trusted person to make healthcare decisions for someone if they are unable to do so themselves, ensuring that their wishes are honored.
- Physician Orders for Life-Sustaining Treatment (POLST): A POLST form complements a DNR order by detailing specific medical interventions a patient desires or wishes to avoid, providing clear instructions for emergency medical personnel.
- Do Not Intubate (DNI) Order: Similar to a DNR, this order specifically instructs healthcare providers not to insert a breathing tube if the patient cannot breathe on their own.
- Organ Donation Consent Form: This document allows individuals to express their wishes regarding organ and tissue donation after death, ensuring that their intentions are known and respected.
- Medical Records Release Form: This form enables individuals to authorize the sharing of their medical information with designated persons, ensuring that their healthcare representatives have access to necessary information.
- Patient Advocate Form: This document allows individuals to appoint someone to act on their behalf in healthcare settings, ensuring that their rights and preferences are upheld during medical treatment.
- Do Not Hospitalize (DNH) Order: This order indicates that a patient should not be admitted to a hospital for treatment, often used for individuals in hospice or palliative care settings.
Understanding these documents can provide peace of mind, ensuring that your healthcare preferences are clearly communicated and respected. It’s essential to discuss these options with loved ones and healthcare providers to ensure everyone is on the same page regarding care decisions.