Homepage / Attorney-Verified Do Not Resuscitate Order Template / Do Not Resuscitate Order Template for the State of Texas
Article Map

The Texas Do Not Resuscitate Order (DNR) form is an important legal document designed to communicate a person's wishes regarding life-sustaining treatments in emergency medical situations. This form is crucial for individuals who wish to forgo resuscitation efforts in the event of a cardiac arrest or respiratory failure. It must be signed by both the patient and a physician, ensuring that medical professionals are aware of and respect the patient's decisions. The DNR form is often accompanied by specific instructions regarding the level of care desired, allowing for clarity in critical moments. Understanding the implications of this document is essential for patients, families, and healthcare providers alike, as it serves to uphold the values and preferences of individuals facing serious health challenges. By clearly outlining a person's wishes, the DNR form helps to alleviate confusion and stress during emergencies, ensuring that medical interventions align with the patient's desires.

Common mistakes

  1. Failing to complete all required sections: The Texas Do Not Resuscitate Order form has specific sections that must be filled out. Omitting any required information can lead to the form being considered invalid.

  2. Not obtaining the necessary signatures: The form must be signed by both the patient and a physician. Without these signatures, the order cannot be honored by medical personnel.

  3. Using outdated versions of the form: It’s important to ensure that the most current version of the Texas Do Not Resuscitate Order form is being used. Older versions may not be recognized by healthcare providers.

  4. Not discussing the order with family members: Failing to communicate the existence and implications of the DNR order with family can lead to confusion and conflict during critical moments.

  5. Misunderstanding the implications of a DNR: Some individuals may not fully grasp what a Do Not Resuscitate Order entails. It’s crucial to understand that this order specifically addresses resuscitation efforts, not other forms of medical treatment.

  6. Neglecting to update the form as circumstances change: Life situations can evolve, and so can a person’s wishes regarding resuscitation. Regularly reviewing and updating the form is essential to ensure it reflects current preferences.

  7. Not keeping copies accessible: After filling out the form, it’s vital to keep copies in easily accessible locations. Healthcare providers must be able to quickly retrieve the order in an emergency.

Key takeaways

Filling out and using the Texas Do Not Resuscitate Order (DNR) form requires careful consideration. Here are key takeaways to keep in mind:

  1. The DNR form is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
  2. It is essential for individuals to discuss their wishes with family members and healthcare providers before completing the form.
  3. The form must be signed by the patient or their legally authorized representative to be valid.
  4. Healthcare providers are required to honor the DNR order as long as it is properly completed and signed.
  5. Keep a copy of the DNR order in a visible location, such as on the refrigerator or with other important medical documents.
  6. Patients can revoke the DNR order at any time, and it is advisable to inform healthcare providers of any changes.
  7. It is recommended to review the DNR order periodically to ensure that it still reflects the patient's current wishes.

Texas Do Not Resuscitate Order Example

Texas Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is created in accordance with Texas Health and Safety Code, Chapter 166. This document allows individuals to express their wishes regarding resuscitation in the event of a medical emergency.

Patient Information:

  • Patient Name: _______________
  • Date of Birth: _______________
  • Address: _______________
  • City, State, Zip Code: _______________

Legal Representative Information (if applicable):

  • Name: _______________
  • Relationship to Patient: _______________
  • Contact Number: _______________

Order Statement:

I, the undersigned, hereby declare my intention not to receive resuscitation efforts, including but not limited to cardiopulmonary resuscitation (CPR), in the event of my cardiac arrest or respiratory failure.

This Order is valid under the following conditions:

  1. This DNR order reflects my wishes after careful consideration.
  2. It is my wish that this order be honored by all medical personnel and facilities treating me.

Signature: ________________________

Date: ________________________

This order will remain in effect until revoked in writing or until a significant change in my medical condition occurs. A copy of this order should be accessible at all times.

Understanding Texas Do Not Resuscitate Order

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

A Texas Do Not Resuscitate Order is a legal document that allows individuals to refuse resuscitation efforts in the event of cardiac or respiratory arrest. It is designed for patients who have a terminal condition or are in a state where resuscitation would not improve their quality of life.

Who can complete a DNR in Texas?

In Texas, a DNR can be completed by a patient who is at least 18 years old and has the capacity to make their own medical decisions. If the patient is unable to do so, a legally authorized representative, such as a family member or guardian, may complete the form on their behalf.

What information is required on the DNR form?

The DNR form requires the following information:

  • The patient's name and date of birth
  • The signature of the patient or their authorized representative
  • The signature of a physician who is familiar with the patient's medical condition
  • The date the order was signed

How does a DNR order work in a medical setting?

Once a DNR order is in place, it must be honored by healthcare providers in emergency situations. If a patient experiences cardiac or respiratory arrest, medical personnel will not perform CPR or other resuscitative measures, as specified in the DNR order.

Can a DNR order be revoked?

Yes, a DNR order can be revoked at any time. The patient or their authorized representative can verbally communicate the revocation to healthcare providers, or they can destroy the physical copy of the DNR form. It's essential to inform all relevant medical personnel about the change.

Where should I keep my DNR order?

It's important to keep the DNR order in a location that is easily accessible to both the patient and healthcare providers. Many individuals choose to keep a copy in their medical records, with their primary care physician, or in a visible place at home, such as on the refrigerator.

Will a DNR order affect my ability to receive other medical treatments?

A DNR order specifically addresses resuscitation efforts and does not affect other medical treatments. Patients will still receive appropriate care, pain management, and other necessary medical interventions, even if they have a DNR in place.

How do I obtain a Texas DNR form?

You can obtain a Texas DNR form from various sources, including:

  • Your healthcare provider or physician's office
  • Hospitals or medical facilities
  • Online through the Texas Department of State Health Services website

Yes, the DNR must be signed by a physician, and it must meet specific criteria outlined by Texas law. Additionally, the patient or their authorized representative must be informed of the implications of the DNR order. It is advisable to consult with a legal or medical professional to ensure compliance with all requirements.

How to Use Texas Do Not Resuscitate Order

Filling out the Texas Do Not Resuscitate Order form is an important step for individuals who want to express their wishes regarding medical treatment in emergencies. Once the form is completed, it should be signed and dated to ensure it is valid. Here’s how to fill it out:

  1. Obtain the Texas Do Not Resuscitate Order form. You can find it online or request a copy from your healthcare provider.
  2. Start by entering your full name at the top of the form.
  3. Provide your date of birth. This helps to confirm your identity.
  4. Indicate whether you are completing the form for yourself or on behalf of someone else. If it’s for someone else, include their name and relationship to you.
  5. In the designated section, clearly state your wishes regarding resuscitation. Be specific about the type of treatment you do or do not want.
  6. Sign the form. Make sure your signature is clear and legible.
  7. Date the form. This is crucial for it to be recognized as valid.
  8. Have a witness sign the form. This can be a friend, family member, or healthcare provider who can confirm that you completed the form willingly.
  9. Keep a copy for your records and provide copies to your healthcare provider and family members.