Navigating end-of-life care decisions is never easy. One of the most important steps you can take to ensure your wishes are respected is completing a Do Not Resuscitate (DNR) order. This article focuses specifically on the do not resuscitate missouri process, providing a detailed explanation of what a DNR is, who can create one, how to properly complete and execute a missouri do not resuscitate form, and where to find a free, downloadable template. I’ve spent over a decade crafting legal templates and assisting individuals with estate planning documents, and I understand the anxiety surrounding these sensitive matters. My goal here is to demystify the process and empower you to make informed decisions about your future healthcare.
What is a Do Not Resuscitate (DNR) Order in Missouri?
A DNR order is a legal document that instructs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if your heart stops beating or you stop breathing. CPR includes chest compressions, electric shock (defibrillation), and artificial ventilation. It’s a critical component of advance care planning, allowing you to maintain control over your medical treatment even when you are unable to communicate your wishes. It’s important to understand that a DNR does not mean you are refusing all medical care. It specifically addresses CPR. You will still receive other medical treatments, such as pain management, antibiotics, and nutrition.
In Missouri, there are two main types of DNR orders:
- Out-of-Hospital DNR (OOH-DNR): This order applies when you are not in a hospital or other medical facility. It’s typically used for individuals who want to avoid CPR if they experience a cardiac or respiratory arrest at home or in a non-hospital setting.
- In-Hospital DNR (IH-DNR): This order applies specifically when you are admitted to a hospital. It’s usually discussed with your doctor while you are a patient.
This article primarily focuses on the Out-of-Hospital DNR, as it requires proactive planning and documentation before a medical emergency occurs.
Who Can Create a Missouri DNR Order?
In Missouri, any competent adult (18 years or older) can create a DNR order. “Competent” means you understand the nature and consequences of your decision. You do not need to be terminally ill to have a DNR. You may choose to have one if you simply don’t want CPR performed under any circumstances.
A healthcare agent appointed through a Durable Power of Attorney for Healthcare can also create a DNR order on your behalf if you are unable to make decisions for yourself. However, the agent must act in accordance with your known wishes or, if those are unknown, in your best interests. It’s crucial to have a clear Durable Power of Attorney for Healthcare document in place before you become incapacitated.
Completing the Missouri DNR Form: A Step-by-Step Guide
The Missouri Department of Health and Senior Services provides a specific form for Out-of-Hospital DNR orders. You can find a link to the official form and detailed instructions on their website: Missouri Department of Health & Senior Services - DNR. Here’s a breakdown of the key sections:
| Section | Description |
|---|---|
| Patient Information | Your full legal name, date of birth, address, and contact information. |
| Healthcare Agent (Optional) | If you have appointed a healthcare agent, provide their name, address, and contact information. |
| Physician’s Statement | This section must be completed by a licensed Missouri physician (MD or DO). The physician will confirm that you are competent and have been informed about the consequences of a DNR order. They will also discuss your medical condition with you. |
| Patient Declaration | This is where you explicitly state your wishes regarding CPR. You will sign and date the form, indicating your understanding and consent. |
| Witnesses | Missouri law requires two adult witnesses who are not related to you, your healthcare agent, or your physician. Witnesses must be present when you sign the form and must also sign the form themselves. They attest to your competence and voluntary decision-making. |
| Emergency Medical Services (EMS) Notification | This section provides instructions for EMS personnel. It typically includes a statement indicating that CPR should not be performed. |
Important Considerations:
- Physician Signature: The form is not valid without a physician’s signature. Schedule an appointment with your doctor to discuss your wishes and have them complete their portion of the form.
- Witness Requirements: Ensure your witnesses meet the legal requirements. They cannot be financially responsible for your care.
- Form Visibility: Once signed and completed, keep the original DNR form in a readily accessible location, such as with your medical records or in a prominent place in your home. Consider also providing a copy to your healthcare agent and EMS. A wallet card indicating you have a DNR is also highly recommended.
Where to Find a Free Downloadable Missouri DNR Form
As mentioned previously, the official Missouri DNR form is available on the Missouri Department of Health and Senior Services website: Missouri Department of Health & Senior Services - DNR. I have also created a simplified template based on the official form, designed to be a helpful starting point. However, always prioritize using the official state form for legal validity.
Download Free Missouri DNR Template (For Reference Only)
Disclaimer: This template is provided for informational purposes only and should not be considered a substitute for the official Missouri DNR form. It is crucial to use the official form and follow all legal requirements.
What Happens When EMS Responds to a DNR Patient?
If you have a valid Missouri DNR order and EMS is called to your location, they are legally obligated to honor your wishes. They will assess the situation, but they will not perform CPR if the DNR order is clearly visible and valid. However, EMS will still provide other necessary medical care, such as administering oxygen, controlling bleeding, and providing pain relief.
It’s important to note that EMS personnel may need to verify the validity of the DNR order. This may involve checking the physician’s signature, witness signatures, and the date of execution. Having a readily accessible and clearly marked DNR order can significantly expedite this process.
Reviewing and Updating Your DNR Order
Your healthcare wishes may change over time. It’s a good practice to review your DNR order periodically, especially if your medical condition changes or if you have a significant life event. You can revoke or modify your DNR order at any time, as long as you are competent. To revoke the order, simply notify your physician and destroy the original form. To modify it, complete a new DNR form with your updated wishes.
The Importance of Discussing Your Wishes with Loved Ones
Completing a DNR order is a significant step, but it’s equally important to discuss your wishes with your family, friends, and healthcare agent. This will ensure that they understand your preferences and can advocate for you if you are unable to do so yourself. Open and honest communication can alleviate stress and prevent misunderstandings during a difficult time.
Resources and Further Information
- Missouri Department of Health & Senior Services: https://health.mo.gov/livingwill/dnr.php
- IRS.gov - Advance Healthcare Directives: While not specific to DNRs, the IRS provides information on the tax implications of certain healthcare expenses related to advance directives. https://www.irs.gov/businesses/small-businesses-self-employed/advance-healthcare-directives
- National Healthcare Decisions Day: https://www.nationalhealthcaredecisionsday.org/ (April 16th)
Final Thoughts on Missouri Do Not Resuscitate Orders
Creating a do not resuscitate missouri order is a deeply personal decision. Taking the time to understand your options and complete a missouri do not resuscitate form can provide peace of mind, knowing that your wishes will be respected. Remember to consult with your physician and legal counsel to ensure your DNR order is valid and reflects your individual circumstances.
Disclaimer: I am not a lawyer, and this article is not legal advice. The information provided herein is for general informational purposes only and should not be substituted for the advice of a qualified legal professional. Laws and regulations are subject to change, and it is your responsibility to ensure compliance with all applicable laws. Always consult with an attorney to discuss your specific legal needs and to ensure your documents are properly prepared and executed.