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The Missouri Do Not Resuscitate Order (DNR) form serves as a critical tool for individuals wishing to express their preferences regarding medical interventions in the event of a life-threatening situation. This legally recognized document allows patients to communicate their desire not to receive cardiopulmonary resuscitation (CPR) or other life-sustaining measures when they are unable to voice their wishes due to a medical condition. The form is designed to be easily accessible, ensuring that healthcare providers can quickly locate and understand a patient's wishes during emergencies. It requires the signatures of both the patient and a physician, reinforcing the importance of medical guidance in these decisions. Furthermore, the DNR form must be presented in a specific format to be valid, which includes clear identification of the patient and the date of the order. In Missouri, this document is not only a personal declaration but also a reflection of broader discussions about patient autonomy and end-of-life care, emphasizing the importance of respecting individual choices in healthcare settings.

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Missouri Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is designed for use in the state of Missouri, compliant with Missouri Revised Statutes Section 190.005 and Section 193.265. This document affirms the patient’s wishes regarding resuscitation efforts.

Patient Information:

  • Name: __________________________
  • Date of Birth: ______________________
  • Address: ___________________________
  • City, State, Zip: ____________________

Health Care Provider Information:

  • Name: __________________________
  • Contact Number: ____________________

Patient’s Directive:

I, the undersigned, hereby declare my intention not to receive cardiopulmonary resuscitation (CPR) or advanced cardiac life support in the event of cardiac or respiratory arrest. I understand this order will be honored by all medical professionals and emergency responders.

Signature of Patient or Legal Representative:

  • Signature: __________________________
  • Date: _______________________________

Witness Information:

  • Name: __________________________
  • Signature: ________________________
  • Date: ___________________________

This DNR Order must be readily available in the patient's medical records and should accompany the patient at all times, especially during transfers for medical care.

Emergency Contact:

  • Name: __________________________
  • Contact Number: ____________________

Please ensure that copies of this order are shared with all relevant healthcare personnel.

Dos and Don'ts

When filling out the Missouri Do Not Resuscitate (DNR) Order form, it is essential to approach the process thoughtfully. Here are some important dos and don'ts to keep in mind:

  • Do ensure that you understand the implications of a DNR order.
  • Do discuss your wishes with your healthcare provider and loved ones.
  • Do fill out the form completely and accurately.
  • Do sign and date the form in the appropriate sections.
  • Don't rush through the form; take your time to consider your decisions.
  • Don't forget to keep a copy of the signed form for your records.
  • Don't assume that verbal instructions are enough; written documentation is crucial.
  • Don't overlook the importance of discussing your DNR wishes with emergency contacts.

Key takeaways

Understanding the Missouri Do Not Resuscitate (DNR) Order form is essential for individuals who wish to make informed decisions about their medical care. Here are some key takeaways to consider:

  1. The DNR order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
  2. Filling out the DNR form requires the signature of the patient or their legal representative, ensuring that the decision is made voluntarily.
  3. The form must be completed in its entirety to be considered valid; incomplete forms may lead to confusion during a medical emergency.
  4. It is important to discuss your wishes with your healthcare provider before completing the DNR form, as they can provide valuable insights.
  5. Once the DNR order is completed, it should be kept in a prominent place, such as on the refrigerator or with other important medical documents.
  6. Healthcare providers and emergency personnel are required to honor the DNR order as long as it is valid and accessible.
  7. Patients can revoke or modify their DNR order at any time, reflecting any changes in their health status or personal wishes.
  8. Family members should be informed of the DNR order to ensure everyone understands and respects the patient’s wishes.
  9. In Missouri, a DNR order can also be part of an advance directive, which outlines broader healthcare preferences beyond resuscitation.

By understanding these key points, individuals can navigate the process of filling out and using the Missouri DNR order form with confidence and clarity.

Misconceptions

Understanding the Missouri Do Not Resuscitate (DNR) Order form is essential for individuals and families considering end-of-life care options. However, several misconceptions often cloud the conversation surrounding this important document. Below are four common misunderstandings:

  • A DNR means no medical care will be provided. This is a prevalent myth. A DNR order specifically indicates that a person does not wish to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest. It does not mean that all medical care will cease. Patients with a DNR can still receive other forms of treatment, including pain management and comfort care.
  • Only terminally ill patients should have a DNR. Many believe that DNR orders are only appropriate for those who are nearing the end of life. In reality, anyone can choose to have a DNR, regardless of their health status. The decision should reflect personal values and preferences regarding resuscitation efforts.
  • A DNR is a legally binding document only if signed by a physician. While a physician's signature is necessary for the DNR to be valid, it is not the only requirement. The patient or their legal representative must also sign the form, indicating their understanding and agreement with the decision. This ensures that the wishes of the individual are respected.
  • A DNR order is permanent and cannot be changed. This misconception can lead to unnecessary anxiety. A DNR order can be revoked or modified at any time by the patient or their legal representative. It is important for individuals to communicate their wishes clearly and to keep their healthcare providers informed of any changes.

By addressing these misconceptions, individuals can make more informed decisions about their healthcare preferences and ensure that their wishes are honored in critical situations.

Similar forms

  • Living Will: A living will outlines a person's wishes regarding medical treatment in situations where they cannot communicate. Like a Do Not Resuscitate Order, it focuses on end-of-life care preferences.
  • Durable Power of Attorney for Healthcare: This document designates someone to make healthcare decisions on behalf of an individual. It complements a DNR by ensuring that a trusted person can advocate for the patient's wishes.
  • Advance Healthcare Directive: An advance directive combines elements of a living will and a durable power of attorney, providing guidance on medical decisions and appointing a representative.
  • Physician Orders for Life-Sustaining Treatment (POLST): POLST forms translate a patient’s wishes into actionable medical orders, similar to a DNR, but can include other treatment preferences as well.
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  • Healthcare Proxy: A healthcare proxy allows an individual to appoint someone to make medical decisions if they become incapacitated. This can work alongside a DNR to ensure wishes are honored.
  • Do Not Intubate (DNI) Order: A DNI order specifically instructs medical personnel not to insert a breathing tube, similar to a DNR in its focus on limiting life-sustaining measures.
  • Comfort Care Order: This order emphasizes comfort and palliative care rather than aggressive treatment. It aligns with the philosophy behind a DNR, prioritizing quality of life.
  • Terminal Illness Declaration: This document states that a patient has a terminal illness and may include treatment preferences. It can support a DNR by clarifying the patient's condition and wishes.
  • Do Not Hospitalize Order: This order requests that a patient not be admitted to a hospital, similar to a DNR, as it reflects a desire to avoid aggressive medical interventions.
  • End-of-Life Care Plan: This comprehensive document outlines a patient's preferences for care at the end of life, including resuscitation wishes, similar to a DNR in its focus on honoring patient choices.