Official Texas Do Not Resuscitate Order Form

Official Texas Do Not Resuscitate Order Form

A Texas Do Not Resuscitate Order (DNR) form is a legal document that allows individuals to refuse resuscitation efforts in the event of cardiac arrest or respiratory failure. This form ensures that a person's wishes regarding end-of-life care are respected by medical personnel. Understanding the implications of a DNR is crucial for both patients and their families in making informed healthcare decisions.

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The Texas Do Not Resuscitate Order (DNR) form is a critical document for individuals wishing to express their preferences regarding medical treatment in the event of a life-threatening situation. This form allows patients to specify that they do not want resuscitation efforts, such as cardiopulmonary resuscitation (CPR), should their heart or breathing stop. It is essential for ensuring that a person’s wishes are respected during emergencies when they may be unable to communicate. The DNR form must be signed by a physician and the patient or their legal representative, providing legal clarity and authority to healthcare providers. Additionally, it is important to understand that this order applies only in specific medical situations and does not affect the provision of other medical care. By completing this form, individuals can take an active role in their healthcare decisions, ensuring that their preferences align with their values and beliefs, especially in critical moments. Understanding the implications and requirements of the Texas DNR form can empower individuals and their families to make informed choices about end-of-life care.

Texas Do Not Resuscitate Order Sample

Texas Do Not Resuscitate Order (DNR)

This Do Not Resuscitate Order is made pursuant to Texas Health and Safety Code § 166.085. It allows individuals to express their wishes regarding resuscitation in case of a medical emergency.

Patient Information:

  • Patient's Full Name: __________________________
  • Patient's Date of Birth: ______________________
  • Patient's Address: _____________________________
  • Patient's Medical Record Number: _______________

Patient's Wishes:

The patient wishes that no attempts be made to resuscitate him/her in the event of cardiac arrest or respiratory failure. This order should be honored in all healthcare settings.

Effective Date:

Date of this Order: __________________________

Signature of Patient or Authorized Representative:

  • Signature: ________________________________
  • Printed Name: ______________________________
  • Relationship to Patient (if applicable): ___________
  • Date: ___________________________________

Witness Information:

  • Witness 1 Signature: _________________________
  • Printed Name: ______________________________
  • Date: ___________________________________
  • Witness 2 Signature: _________________________
  • Printed Name: ______________________________
  • Date: ___________________________________

Healthcare Provider Acknowledgment:

  • Healthcare Provider Signature: ________________
  • Printed Name: ______________________________
  • Date: ___________________________________

This DNR Order will remain in effect until revoked or modified by the patient or their representative.

Documents used along the form

The Texas Do Not Resuscitate (DNR) Order form is an important document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. Alongside the DNR form, several other documents can support a person's healthcare decisions. Here is a list of commonly used forms and documents that may accompany the Texas DNR Order.

  • Advance Directive: This document outlines a person's preferences for medical treatment in situations where they may be unable to communicate their wishes. It can include instructions on life-sustaining treatments and end-of-life care.
  • Medical Power of Attorney: This form designates a specific individual to make healthcare decisions on behalf of the person if they become incapacitated. It ensures that someone trusted is making choices aligned with the person's values.
  • Living Will: A living will provides guidance on the types of medical treatment a person wishes to receive or avoid in critical situations. It focuses on end-of-life decisions and can clarify a person’s stance on life-sustaining measures.
  • Last Will and Testament: To ensure your estate is handled according to your preferences, refer to our comprehensive Last Will and Testament guidelines for clear instructions and legal compliance.
  • Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order that translates a patient's treatment preferences into actionable orders for healthcare providers. It is especially useful for those with serious illnesses.
  • Do Not Intubate (DNI) Order: This document specifies that a patient does not wish to be intubated or placed on a ventilator. It can be used in conjunction with a DNR order to clarify treatment preferences.
  • Organ Donation Consent: This form expresses a person's wishes regarding organ and tissue donation after death. It can be included with other advance care planning documents to ensure that healthcare providers are aware of these wishes.
  • Healthcare Proxy: Similar to a medical power of attorney, this document appoints someone to make healthcare decisions on behalf of a person. It can be useful in situations where the individual cannot voice their preferences.
  • Patient Information Form: This document gathers essential information about the patient, including medical history and current medications. It assists healthcare providers in delivering appropriate care in emergencies.

These documents work together to ensure that an individual's healthcare preferences are respected and followed. Having a comprehensive set of advance care planning documents can provide peace of mind for both patients and their families during difficult times.

Discover Other Common Do Not Resuscitate Order Forms for US States

Key takeaways

Understanding the Texas Do Not Resuscitate Order (DNR) form is essential for making informed healthcare decisions. Here are some key takeaways to consider:

  • The DNR form allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency.
  • It is important to complete the form accurately and ensure it is signed by both the patient and a physician to be valid.
  • The completed DNR form should be easily accessible to healthcare providers, ideally kept with other important medical documents.
  • Patients and their families should discuss the DNR order openly to ensure everyone understands the implications and respects the individual's wishes.

Document Properties

Fact Name Description
Governing Law The Texas Do Not Resuscitate Order is governed by the Texas Health and Safety Code, Chapter 166.
Purpose This form allows individuals to refuse resuscitation efforts in the event of a medical emergency.
Eligibility Any adult can complete a Do Not Resuscitate Order, provided they are of sound mind.
Signature Requirements The form must be signed by the individual or their legal representative, along with a witness.
Revocation A Texas Do Not Resuscitate Order can be revoked at any time by the individual.
Healthcare Provider Obligations Healthcare providers must honor the order as long as it is properly completed and signed.

Frequently Asked Questions

What is a Texas Do Not Resuscitate Order (DNR) form?

A Texas Do Not Resuscitate Order (DNR) form is a legal document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. When a DNR order is in place, healthcare providers are instructed not to perform cardiopulmonary resuscitation (CPR) or other life-saving measures if the individual stops breathing or their heart stops beating. This form is particularly important for individuals with terminal illnesses or those who wish to avoid aggressive medical interventions at the end of life.

Who can complete a DNR form in Texas?

In Texas, a DNR form can be completed by any adult who is capable of making informed decisions about their medical care. This includes individuals aged 18 and older. If the person is unable to complete the form due to incapacity, a legally authorized representative, such as a family member or a designated healthcare proxy, may sign the form on their behalf. It is crucial that the individual's wishes are clearly understood and respected.

How do I obtain a DNR form in Texas?

Obtaining a Texas DNR form is straightforward. You can acquire a copy from various sources, including:

  1. Healthcare providers, such as hospitals or clinics.
  2. Online from the Texas Department of State Health Services website.
  3. Local health departments or hospice organizations.

Once you have the form, it is essential to complete it accurately and have it signed by the appropriate parties.

What should I do after completing the DNR form?

After completing the DNR form, it is vital to ensure that it is easily accessible. Here are some steps to follow:

  • Keep a copy in a prominent location, such as on the refrigerator or with other important medical documents.
  • Provide copies to your healthcare providers, including your primary care physician and any specialists involved in your care.
  • Share the information with family members and close friends to ensure they are aware of your wishes.

Communicating your preferences helps to ensure that your wishes are honored in a medical emergency.

Can I change or revoke my DNR order?

Yes, you can change or revoke your DNR order at any time. If you wish to make changes, simply complete a new DNR form and ensure it is signed and distributed as needed. To revoke an existing DNR order, you can verbally inform your healthcare providers or family members, and it is advisable to destroy any copies of the previous form to prevent confusion. Always communicate your current wishes clearly to those involved in your care.

What happens if I do not have a DNR form in place?

If you do not have a DNR form in place and experience a medical emergency, healthcare providers are required to perform life-saving measures, such as CPR. This may not align with your wishes if you prefer to avoid such interventions. Therefore, it is important to have a DNR form if you want to ensure your preferences are respected. Without it, decisions about your care may default to standard emergency protocols, which may not reflect your desires regarding end-of-life care.

Misconceptions

Understanding the Texas Do Not Resuscitate (DNR) Order form is crucial for individuals and families making end-of-life decisions. Here are nine common misconceptions about the Texas DNR Order form, along with clarifications.

  1. A DNR means no medical treatment at all. Many believe that a DNR order prohibits all forms of medical treatment. In reality, a DNR only applies to resuscitation efforts during cardiac or respiratory arrest. Other medical treatments can still be administered.
  2. Only terminally ill patients can have a DNR. This is a common misunderstanding. While DNR orders are often associated with terminal illnesses, any patient can request a DNR if they wish to avoid resuscitation in specific situations.
  3. A DNR is the same as a living will. Although both documents relate to end-of-life decisions, they serve different purposes. A living will outlines a person's wishes regarding medical treatment, while a DNR specifically addresses resuscitation efforts.
  4. A DNR is only valid in hospitals. Some think that a DNR order is only applicable in hospital settings. In Texas, a DNR order is valid in both hospital and out-of-hospital settings, as long as it is properly completed and signed.
  5. Once a DNR is signed, it cannot be changed. This misconception suggests that a DNR is permanent. In fact, individuals can revoke or modify their DNR orders at any time, as long as they are capable of making decisions.
  6. Healthcare providers must follow a DNR order in all situations. While healthcare providers are generally required to honor a DNR order, there are exceptions. For instance, if a patient is in a situation where they can be saved without resuscitation, providers may take action to stabilize the patient.
  7. Family members can override a DNR order. Many assume that family members can change a DNR order. However, only the individual who signed the DNR or their legally authorized representative can make changes to it.
  8. A DNR order must be notarized to be valid. Some people believe that notarization is necessary for a DNR order. In Texas, a DNR form does not need to be notarized; it simply requires the signatures of the patient and a physician.
  9. Having a DNR means giving up on life. This misconception suggests that choosing a DNR signifies a lack of hope. In reality, a DNR reflects a person's values and preferences regarding their quality of life and the type of care they wish to receive.

Understanding these misconceptions can help individuals and families make informed decisions about DNR orders and ensure that their wishes are respected in medical situations.