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In Texas, the Do Not Resuscitate (DNR) Order form serves as a critical tool for individuals wishing to communicate their healthcare preferences in emergency situations. This form allows patients to specify their desire to forgo cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. It is essential for individuals facing serious illnesses or those who wish to plan ahead for end-of-life care. The DNR Order must be signed by both the patient and their physician, ensuring that the patient’s wishes are respected and legally recognized. Additionally, the form should be readily accessible to healthcare providers, as it guides their actions during emergencies. Understanding the implications and requirements of the DNR Order is vital for patients, families, and healthcare professionals alike, as it fosters informed decision-making and honors personal autonomy in medical care.

Document Attributes

Fact Name Description
Definition A Texas Do Not Resuscitate (DNR) Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
Governing Law The Texas DNR Order is governed by the Texas Health and Safety Code, Chapter 166.
Eligibility Any adult with a terminal condition or irreversible condition can complete a DNR Order, provided they are capable of making their own medical decisions.
Signature Requirement The DNR Order must be signed by the patient or their legally authorized representative, along with a physician's signature.
Effectiveness The DNR Order is effective only when it is properly completed and presented to emergency medical personnel.

Similar forms

  • Living Will: A living will outlines a person's wishes regarding medical treatment in situations where they cannot communicate. Like a DNR, it provides guidance to healthcare providers about the individual's preferences for end-of-life care.

  • Healthcare Power of Attorney: This document designates a person to make medical decisions on behalf of someone else. Similar to a DNR, it ensures that medical choices align with the patient's wishes, especially in critical situations.

  • Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that specifies a patient's preferences for life-sustaining treatments. It serves a similar purpose as a DNR by communicating the patient's desires to healthcare providers.

  • Living Will: To clarify your medical treatment preferences, consider the essential Living Will form available online for seamless documentation of your wishes.

  • Advance Healthcare Directive: An advance healthcare directive combines elements of a living will and a healthcare power of attorney. It provides instructions for medical care and appoints someone to make decisions, akin to a DNR's intent to limit interventions.

  • Do Not Intubate (DNI) Order: A DNI order specifically instructs healthcare providers not to place a patient on a ventilator. Like a DNR, it reflects the patient's wishes regarding life-sustaining measures in critical care situations.

Free Do Not Resuscitate Order File

Texas Do Not Resuscitate Order Example

Texas Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is prepared in accordance with Texas law regarding medical directives. It allows individuals to express their preferences regarding resuscitation in the event of a medical emergency.

Patient Information:

  • Name: ________________________________
  • Date of Birth: _______________________
  • Address: _____________________________
  • City: ________________________________
  • State: _______________________________
  • Zip Code: ____________________________

Physician Information:

  • Name: ________________________________
  • Contact Number: ______________________
  • Office Address: _______________________

Order Statement:

I, the undersigned, declare that I do not wish to receive cardiopulmonary resuscitation (CPR) or other life-sustaining treatment in the event that my heart or breathing stops. This decision is made freely, voluntarily, and without coercion.

Effective Date: This DNR order becomes effective upon signature.

Signature of Patient or Legal Representative: ________________________________

Date: __________________________________

Witness Signatures:

  1. _______________________________ Date: ________________
  2. _______________________________ Date: ________________

This document should be kept in an accessible location and shared with healthcare providers, family members, and anyone involved in your medical care.

Understanding Texas Do Not Resuscitate Order

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. Specifically, it instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) or other life-saving measures if the individual’s heart stops beating or they stop breathing. This form is especially important for those with terminal illnesses or severe health conditions who wish to avoid aggressive medical interventions at the end of life.

Who can complete a DNR form in Texas?

In Texas, any competent adult can complete a DNR form. This includes individuals who are at least 18 years old and capable of making informed decisions about their healthcare. Additionally, a parent or legal guardian may complete a DNR for a minor. It is essential that the person completing the form understands its implications and has discussed their wishes with their healthcare provider and loved ones.

How do I obtain a Texas DNR form?

You can obtain a Texas DNR form through various sources. The Texas Department of State Health Services provides downloadable versions of the form on its website. Hospitals, healthcare providers, and hospice organizations may also have copies available. It is important to ensure that you are using the most current version of the form, as regulations and requirements may change over time.

What should I do after completing the DNR form?

Once you have completed the Texas DNR form, it is crucial to share copies with your healthcare provider and any family members or caregivers involved in your care. The form should be kept in a prominent place, such as on your refrigerator or with your medical records, so that it is easily accessible in an emergency. Make sure to discuss your wishes with your healthcare team to ensure they understand and respect your decisions.

Can a DNR order be revoked or changed?

Yes, a DNR order can be revoked or changed at any time. If you decide to alter your wishes, simply destroy the original DNR form and complete a new one that reflects your current preferences. It is advisable to notify your healthcare provider and family members of any changes to ensure that everyone is aware of your updated wishes. Keeping open lines of communication is essential in these situations.

Dos and Don'ts

When filling out the Texas Do Not Resuscitate Order form, it is crucial to follow specific guidelines to ensure that your wishes are clearly communicated. Here are some essential do's and don'ts:

  • Do ensure that you fully understand the implications of the Do Not Resuscitate Order.
  • Do consult with your healthcare provider to discuss your wishes and any medical conditions.
  • Do sign the form in the presence of a witness, as required by Texas law.
  • Do keep a copy of the completed form in an accessible location for your healthcare team.
  • Don't fill out the form under pressure or without considering your options.
  • Don't forget to update the form if your health situation changes.
  • Don't leave the form unsigned or incomplete, as it may not be honored.
  • Don't assume that verbal instructions are sufficient; always use the official form.

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