Living wills and do-not-resuscitate (DNR) orders are both part of advance directives for health care. They determine what medical professionals should do when you're unable to make decisions about your care — for example, when you're in a coma or unconscious due to cardiac arrest.
However, these two forms of advance directives serve different purposes regarding your medical care, so it's important to consider both when deciding about the care you'd like to receive. To help you understand the difference, read on to learn more about living wills and DNRs.
What Is a Living Will?
Living wills communicate your wishes about life support and other forms of end-of-life care. Medical technology has advanced to the point where patients can be kept alive for extraordinary periods of time, even if they're unable to eat or breathe on their own. Hospital staff will provide this care even when there's absolutely no chance of recovery.
If you don't want to receive this type of care, it's important for you to fill out a living will. It's a legal document that medical providers will follow if you are incapacitated. You can express your wishes about whether or not you want to receive tube feeding when you're unable to eat or antibiotics when you have an infection.
When you send your living will to your primary care physician, he or she enters it into your electronic health records. If you're admitted to the hospital and your doctor sends them a copy of your records, they will have your entire wishes on file. Every physician who looks up your medical records will be notified, allowing them to treat you according to your wishes.
What Is a DNR?
DNRs apply to cardiopulmonary resuscitation (CPR) rather than to end-of-life care. If you don't have a DNR on file, medical personnel will do everything that they can in order to resuscitate if you stop breathing or if your heart stops. This can include chest compressions, mechanical ventilation, electrical defibrillation, and the intravenous injection of medication such as norepinephrine that can restart your heart. As part of your DNR, you can specify which of these measures, if any, that you'd like used if you need CPR.
In order to create a DNR, you only need to ask your primary care physician. It's entered into your medical records like a living will, but you don't have to draft a legal document for it.
Do You Need Both a Living Will and a DNR?
You'll need to consider both in order to fully express your advance directives for health care. A living will doesn't prevent you from being resuscitated, and a DNR doesn't prevent you from being placed on a feeding tube — as long as your heart is still beating and you can breathe on your own, your DNR never comes into play.
Can You Change Your Mind About Your Advance Directives?
You can change your living will or cancel it at any time as long as you're alert and have the capacity to make medical decisions. The same applies to DNR orders. They're only effective when you can no longer make medical decisions on your own. If you're admitted to the hospital and change your mind about your advance directives, you can speak to a physician to have your electronic health records amended. Since it's easy to amend your wishes about end-of-life care, it's a good idea to begin planning for end-of-life care no matter your age.
End-of-life care is a complex topic, and states have varying rules regarding advance directives. If you need to create a living will, it's important to speak to an attorney at a local law firm like Wright Law Offices, PLLC. This ensures that your living will complies with state law and is unambiguous. When your advance directives can be easily understood, physicians will be able to interpret them appropriately to fulfill your wishes regarding care.
