DNR vs. Life Sustaining Treatment

Every estate plan should include a document naming someone else to handle medical decisions when you are no longer able to.  The terminology most commonly associated with this document includes: a medical directive, advanced directive, living will, patient advocate, and health care power of attorney.  No matter the name, this document contains important language about who gets to make decisions for you when you cannot speak for yourself, what powers the person has to handle your medical and mental treatment needs, and what should be done in the event you are not expected to live off of life support. 

For those of us who have no medical training, terminology is easily misused when talking about end-of-life decisions.  When this subject comes up in estate planning, people readily volunteer that they want a DNR (short for do-not-resuscitate).  But life support and a DNR are distinctive and important to understand.

Michigan has a Do-Not- Resuscitate Procedure Act.  If you have signed a DNR and are in a medical facility – medical professionals are on notice that if your heart and breathing stop, you do not want to be revived.  This Act also extends outside a medical facility.  For example, if someone is at home and their heart and breathing stop – medical professionals would usually work to revive this person.  But, if they have a DNR that is visible to the medical professionals, such as a DNR bracelet, they must honor that person’s wishes and cannot attempt to revive that person.  For most people, until we reach an advanced age, or a precarious medical situation exists – most of us do want to be revived if we have a chance of returning to our normal way of life.  In a situation where you are not breathing – it is the responsibility of medical professionals to save your life (unless you have a visible DNR). Because time is precious, it is not feasible to contemplate what your recovery will be like once revived.

What most people unknowingly mean when they refer to a DNR is that they don’t want to be kept alive on life support if it is not expected they will be able to ever live off such support.  The health care power of attorney will specify what should happen in this scenario including whether you intend or don’t intend for nutrition and hydration to be withheld.  A health care power of attorney can authorize the person making your medical decisions to sign a DNR on your behalf.  Further, if you wish to have a DNR in place, you should speak with a medical professional such as your doctor to make sure you understand the implications of a DNR before signing one.

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