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Homepage Valid Do Not Resuscitate Order Form Attorney-Approved Do Not Resuscitate Order Template for the State of Texas

Form Specifications

Fact Name Details
Purpose The Texas Do Not Resuscitate (DNR) Order form allows individuals to refuse resuscitation efforts in case of cardiac or respiratory arrest.
Governing Law The DNR Order is governed by the Texas Health and Safety Code, Section 166.081 - 166.085.
Eligibility Any adult can complete a DNR Order, as long as they are of sound mind and understand the implications.
Signature Requirement The form must be signed by the individual or their legal representative, along with a physician's signature.
Form Availability The Texas DNR Order form is available online and can also be obtained through healthcare providers.
Revocation A DNR Order can be revoked at any time by the individual or their legal representative.
Notification It is important to inform healthcare providers and family members about the existence of the DNR Order.
Emergency Medical Services Emergency medical personnel are required to honor a valid DNR Order in Texas.
Additional Documentation In some cases, a DNR Order may need to be accompanied by an advance directive or living will.

Dos and Don'ts

When filling out the Texas Do Not Resuscitate Order form, it is crucial to understand the implications and requirements. Below is a list of things you should and shouldn't do to ensure the form is completed correctly.

  • Do discuss your wishes with your healthcare provider before completing the form.
  • Do ensure that the form is signed by the appropriate parties, including a physician.
  • Do keep a copy of the completed form in a visible place, such as with your medical records.
  • Do review the form periodically to ensure it still reflects your wishes.
  • Don't fill out the form without understanding its implications for your medical care.
  • Don't forget to inform family members about your decision and where the form is located.

Common mistakes

  1. Incomplete Information: Failing to provide all required personal details can lead to confusion. Ensure that names, dates of birth, and other identifying information are filled out completely.

  2. Not Signing the Form: A common oversight is neglecting to sign the form. Without a signature, the order is not valid. Always double-check that the form is signed by the patient or their legal representative.

  3. Missing Witness Signatures: In Texas, the Do Not Resuscitate Order must be witnessed. Forgetting to include witness signatures can invalidate the document. Make sure to have two qualified witnesses sign the form.

  4. Not Keeping Copies: After completing the form, individuals often forget to make copies. Keep several copies in accessible locations, such as with your healthcare provider and family members, to ensure that it can be easily referenced when needed.

Documents used along the form

When considering a Texas Do Not Resuscitate (DNR) Order, it is important to understand that this document often works in conjunction with other forms that help outline your healthcare wishes. These additional documents provide clarity and ensure that your preferences are respected in various medical situations. Below are some common forms that are frequently used alongside a DNR Order.

  • Advance Directive: This document allows individuals to specify their healthcare preferences in case they become unable to communicate their wishes. It can include instructions about life-sustaining treatments, organ donation, and appointing a healthcare agent.
  • Dog Bill of Sale: This legal document is essential for transferring ownership of a dog and includes vital information about the dog to ensure both parties are protected in the transaction. Understanding this document can be beneficial when buying or selling a dog. More information can be found at https://californiadocsonline.com/dog-bill-of-sale-form/.
  • Medical Power of Attorney: This form designates a trusted person to make medical decisions on your behalf if you are incapacitated. It is essential for ensuring that someone who understands your values and preferences can advocate for you.
  • Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order that outlines a patient’s preferences for emergency medical care. It is typically used for individuals with serious illnesses and complements the DNR Order by detailing other treatment preferences.
  • Living Will: A living will is a type of advance directive that specifically addresses your wishes regarding end-of-life care. It provides guidance on whether to continue or withdraw life-sustaining treatment when recovery is unlikely.

By understanding these documents, you can create a comprehensive plan that reflects your healthcare wishes. This ensures that your choices are honored, providing peace of mind for both you and your loved ones.

Misconceptions

Understanding the Texas Do Not Resuscitate (DNR) Order form is crucial for both patients and their families. However, several misconceptions often arise regarding its purpose and implications. Here are four common misunderstandings:

  1. The DNR Order means that no medical care will be provided.

    This is not accurate. A DNR Order specifically instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if a patient’s heart stops or they stop breathing. However, it does not prevent other forms of medical care or treatment from being administered. Patients will continue to receive necessary medical attention, comfort measures, and pain management.

  2. Only terminally ill patients can have a DNR Order.

    This misconception overlooks the fact that a DNR Order can be appropriate for anyone who wishes to decline CPR in the event of a cardiac arrest, regardless of their overall health status. It is a personal decision based on individual values and preferences about end-of-life care.

  3. A DNR Order is permanent and cannot be changed.

    In reality, a DNR Order can be revoked or modified at any time by the patient or their legal representative. It is essential for individuals to communicate their wishes clearly and ensure that any changes are documented properly.

  4. The DNR Order is only valid in hospitals.

    This is a common misunderstanding. In Texas, a properly executed DNR Order is valid in various settings, including hospitals, nursing homes, and even at home. However, it is important to ensure that the order is recognized by all medical personnel involved in the patient’s care.

Being informed about these misconceptions can help individuals make better decisions regarding their healthcare preferences and ensure that their wishes are respected in critical situations.

Preview - Texas Do Not Resuscitate Order Form

Texas Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is created in accordance with Texas state laws regarding advanced care planning.

Please complete the following information:

  • Patient's Full Name: ____________________________
  • Date of Birth: ____________________________
  • Patient's Address: ____________________________
  • Patient's Healthcare Provider: ____________________________
  • Healthcare Provider's Phone Number: ____________________________

This document states that if the patient’s heart stops beating or if breathing ends, no attempts should be made to restart the heart or lungs.

Patient's Wishes:

I, the undersigned patient, do not wish to receive cardiopulmonary resuscitation (CPR) or other life-sustaining treatment if my heart or breathing stops.

By signing this order, I acknowledge that:

  1. I understand the consequences of this decision.
  2. This DNR order reflects my wishes regarding resuscitation.
  3. This order should be honored by all healthcare professionals.

Signature of Patient: ____________________________

Date: ____________________________

If the patient is unable to sign, the following individual may sign on their behalf:

  • Representative's Full Name: ____________________________
  • Relationship to Patient: ____________________________
  • Signature of Representative: ____________________________
  • Date: ____________________________

This DNR order is valid indefinitely unless revoked or amended.

Ensure that copies of this document are provided to all healthcare providers involved in the patient’s care.

Key takeaways

When considering the Texas Do Not Resuscitate (DNR) Order form, it is essential to understand its purpose and implications. Here are some key takeaways to keep in mind:

  • The DNR order allows individuals to refuse resuscitation in the event of cardiac or respiratory arrest.
  • It must be signed by a physician and the patient or their legal representative to be valid.
  • The form should be easily accessible, ideally kept with other important medical documents or on the refrigerator.
  • Regularly review and update the DNR order to ensure it reflects current wishes and medical conditions.

Similar forms

  • Living Will: A living will outlines an individual's preferences regarding medical treatment in the event they become unable to communicate. Like a DNR, it provides guidance on end-of-life care.
  • Healthcare Power of Attorney: This document designates someone to make healthcare decisions on behalf of an individual. Similar to a DNR, it ensures that a person's wishes are respected when they cannot voice them.
  • Hold Harmless Agreement: This agreement is essential to safeguard parties involved in various activities, ensuring that participants acknowledge the risks and agree not to hold others accountable, as highlighted in the Forms Washington resources.
  • Advance Healthcare Directive: An advance healthcare directive combines elements of both a living will and a healthcare power of attorney. It specifies medical preferences and appoints a decision-maker, akin to a DNR's intent.
  • POLST (Physician Orders for Life-Sustaining Treatment): A POLST form translates patient preferences into actionable medical orders. Like a DNR, it communicates wishes about resuscitation and other life-sustaining treatments.
  • Do Not Intubate (DNI) Order: A DNI order specifies that a patient should not be intubated if they stop breathing. This document, similar to a DNR, focuses on limiting invasive medical interventions.
  • Comfort Care Order: This order emphasizes providing comfort and alleviating suffering rather than pursuing aggressive treatment. It aligns with the principles of a DNR by prioritizing quality of life.
  • Patient Autonomy Document: This document asserts a patient's right to make their own healthcare decisions. It shares a common goal with a DNR in honoring individual choices regarding medical interventions.
  • End-of-Life Care Plan: An end-of-life care plan outlines preferences for care during the final stages of life. Like a DNR, it aims to ensure that medical treatment aligns with the patient’s values and desires.