In our recent DNR (Do Not Resuscitate) Order guide, we explained that a DNR can be written by a physician, a patient, or other authorized individual. The order refuses certain medical interventions when the patient does not want to be resuscitated. This might be done when resuscitation efforts may not be in the best interest of the patient, such as when it would only prolong imminent death.
The effects of a DNR form are serious. It can make the difference between two outcomes: life or death. Because of this, DNR forms can be controversial. There are cases when a family member may disagree with your wishes or a physician’s recommendation. They may also want to know their rights in case they suspect an error has been made. Can a DNR be revoked by family members? In this guide, we explore the answer to this controversial but important question.
Can a DNR Order Be Revoked?
Yes, a DNR order can be revoked. A DNR order can be signed by an individual, or their legally-recognized health care agent. If you wish to cancel your DNR order, simply notify your attending physician. They are required to remove the order from your medical record. Your medical health care agent can also do this on your behalf if you are unable to communicate your wishes.
Can a DNR Be Revoked by Family?
“Can a DNR be revoked by family?” This question can come up from family members who are concerned for their loved one and feel as though a DNR should not be in place. This could happen if they don’t agree with the physician’s recommendation, or fear that an error has been made. According to the National Library of Medicine, medical error is the third-leading cause of death in the U.S., so such a fear is not always off-base.
However, only a physical, the patient, or the patient’s healthcare agent can revoke a DNR. The only instance in which a family member can revoke a DNR is when that same family member is also the patient’s healthcare agent. If the patient authorized that family member to serve as their agent through their Medical Power of Attorney document, then that family member does have the power to cancel the DNR. However, they are ethically bound to complying with the patient’s end-of-life wishes.
Can Family Override DNR?
As explained earlier, the only entities that have the legal power to override a DNR is a physician, the patient, or the patient’s healthcare agent.
A physician would only write a DNR order in extreme cases, such as when they believe that any attempts to resuscitate the patient would be in vain. This could be when it would only prolong death that is inevitable. Medical interventions can be quite invasive, and if the patient were to pass away, their loved ones may not have the chance to say goodbye before they take their last breath. A physician may override a DNR if the patient’s medical conditions have changed or believe that the DNR was made in error.
Similarly, a patient may override the DNR if they believe it was written in error or they simply change their mind.
The only instance in which family might be able to override a DNR is if one of those family members is also the patient’s authorized healthcare agent. However, they can’t do so simply because they disagree with the patient’s last wishes or the doctor’s orders. A family agent appointed through a Medical Power of Attorney has the legal responsibility to abide by the patient’s end-of-life care instructions.
How Can a DNR be Overridden?
As the patient, you have the right to change your mind about a DNR and request CPR at any time. The attending physician is ultimately responsible for processing this change in your medical records, so it is imperative that you or your healthcare agent communicate this decision to them right away.
A DNR is overridden by removing it from the patient’s medical records. In addition, the patient and/or their caretakers should be careful to destroy any physical DNR forms, cards, and associated identification items. (For example, the hospital may have provided colored-coded bracelets or anklets to help medical staff easily identify a DNR patient) This will help prevent any miscommunications or errors in case an emergency occurs. Things can get especially confusing when a patient is transferred from one facility or department to another and the receiving staff are not aware that the DNR was canceled.
Last but not least, you have the right to change your mind about the extent of medical intervention you’d want, or the conditions in which you’d want them. When this is the case, you must request to cancel and destroy their current DNR order and write a new one.
What if the Family Disagrees with the DNR Order?
If the family disagrees with the DNR order, then they have a right to speak with the attending physician. The physician should make a reasonable effort to explain the patient’s prognosis and treatment options, along with the patient’s wishes. This alone can help clear up any misunderstandings. If a transparent conversation with the primary physician does not help, the family can also request meetings with other members of the healthcare team. Oftentimes, these conversations can lead to agreement and common understanding.
However, there are cases in which a family will still disagree, leading to conflict. Healthcare facilities are required to provide tools for resolving these conflicts. For instance, they may have access to a social worker or patient representative who works at the hospital. This professional may provide tools and resources on how to proceed. It may be recommended to the family that they present their case to the hospital’s ethics committee.
Ultimately, however, the decision to write a DNR order rests with the physician and the patient. Family disagreements and opinions unfortunately do not reverse a DNR order when the patient themself requested the DNR. This can understandably be a hard pill for loving family members to swallow, making it difficult for them to accept at first.
How to Set Up a DNR
Can a DNR be revoked by family? The only instance in which a family member can revoke a DNR that was signed by both the doctor and the patient is when that family member is also the patient’s authorized health care agent. They should only do so when the patient changed their mind about the DNR, or they believe that the doctor has written the DNR order in error. Ultimately, family members can present their case to the hospital’s ethics committee if they cannot reach a resolution.
When reading this guide, you may have gotten a sense that these life-or-death matters can become quite a nightmare when the correct answer is not clear. Decision-making can become emotionally charged, and family members may not agree with your decision or the doctor’s decision. Further, there’s also the scary risk of human error, especially when things are happening so quickly.
The best way to protect yourself is by creating an Advance Directive. These are healthcare-related documents that you can set up as a part of your Estate Plan. In these documents, you can set up a Medical Power of Attorney and elect your trusted health care agent. You can also make your end-of-life care wishes known by leaving specific instructions, plus a DNR order. You can view our complete guide on Advance Directives here.
Even if you do not have a DNR order when it may be needed, your healthcare agent is authorized to sign an order on your behalf. By leaving crystal-clear instructions, you can reduce the risk of others making the wrong call.
Start setting up your Advance Directive today. Trust & Will has made the process as easy, seamless, and affordable as possible. That way, you can have peace of mind knowing that your wishes are known. Further, if you were to become incapacitated, you authorized a trusted individual to make judgment calls on your behalf. This removes the burden from your loved ones having to make difficult decisions, especially when in an ethical gray area.
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