Our dad was hospitalized last month and signed a DNR.   Does he still need a Living Will? Essentially what this individual conveyed is that their father made an extremely important decision without appropriate guidance.

Most people understand that “DNR” stands for “Do Not Resuscitate”. However, it is not always obvious what this statement means. If an individual signs a DNR, she has essentially created a medical order demanding that no one provide CPR. The patient is rejecting everything from chest compressions to EKG treatment. Basically, she is ordering the medical staff to stand by and do nothing if she stops breathing.

On the other hand, a Living Will specifically dictates that only in the event she falls into a permanent vegetative state or a doctor determines that there is no hope of recovery does she not want heroic measures taken to save her life. Often the Living Will directs that only pain relieving measures shall be taken during the natural dying process. A DNR does not address pain relief medications or nutrition, only resuscitation.

So how do these documents interact in a typical situation?

Scenario A: Patient has a DNR and no Living Will. Patient suffers a heart attack in a facility. The DNR states that the patient shall not be revived and the patient dies on the spot – even if Patient may have enjoyed a full recovery.

Scenario 2: No DNR and Patient has a Living Will. Patient chokes on her dinner at facility. The medical staff performs CPR but is unsuccessful and Patient falls into a coma. The doctor determines that the patient lacks adequate brain activity from a lack of oxygen and is now in a permanent vegetative state. In accordance with the Living Will, Patient is provided nutrition and pain relief medication until she passes away.

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