Official Do Not Resuscitate Order Form for the State of West Virginia

What is a Do Not Resuscitate Order (DNR) in West Virginia?

A Do Not Resuscitate Order (DNR) in West Virginia is a legal document that instructs medical professionals not to perform cardiopulmonary resuscitation (CPR) if a person's heart stops beating or if they stop breathing. This order is typically requested by the patient or their legal guardian and must be signed by a licensed physician to be valid.

How can someone obtain a DNR order in West Virginia?

To obtain a DNR order in West Virginia, an individual must discuss their wishes with their healthcare provider. If the provider agrees that a DNR order is appropriate based on the individual's health condition and personal preferences, the provider will prepare the order. The patient or their legal representative and the physician must sign the form for it to be considered valid.

Is the West Virginia DNR Order effective in all healthcare settings?

Yes, once a DNR order is signed and in place, it is recognized and effective in all healthcare settings within West Virginia. This includes hospitals, long-term care facilities, and in-home care settings. Healthcare providers across the state are legally bound to respect the wishes documented in a DNR order.

Can a DNR order be revoked or changed once it has been put in place?

Yes, a DNR order can be revoked or changed at any time. The individual who requested the DNR order, or their legal representative, can decide to cancel or modify the order. For the revocation or change to be effective, the individual or their representative must inform their healthcare provider about their new decision, and the provider will update the medical records accordingly.

What should be done with the DNR order once it has been signed?

Once a DNR order has been signed, it is important to ensure that it is easily accessible to healthcare providers. Copies of the order should be kept in a place where they can be readily found in case of an emergency, such as with personal identification, in a wallet, or displayed in a prominent location in the home. Additionally, a copy should be given to all healthcare providers involved in the person's care to ensure that the order is included in the person's medical records.

Does having a DNR order affect the quality of care a person receives?

No, having a DNR order does not affect the quality of care a person receives. Healthcare professionals will continue to provide all other necessary medical treatments and interventions to ensure comfort and maintain quality of life. The DNR order simply indicates the person's wish not to have CPR performed in the event that their breathing stops or their heart ceases to beat.

Filling out a West Virginia Do Not Resuscitate (DNR) Order form is a significant decision that requires careful consideration and attention to detail. Unfortunately, common mistakes can lead to confusion, delays, or even failure to honor the individual's wishes. Being mindful of these errors can help ensure that the document reflects the person’s true intentions and can be executed appropriately when needed.

1. Not consulting with a healthcare provider: One of the most critical steps in completing a DNR Order is discussing it with a healthcare provider. This professional can offer essential insights into the individual's health status and help clarify the implications of a DNR order. Skipping this discussion can lead to misinformed decisions.

2. Failing to properly identify the individual: The DNR Order requires accurate identification of the person it pertains to. This includes their full legal name, date of birth, and other identifying information. Any discrepancies or incomplete details can render the order difficult to enforce or recognize in an emergency.

3. Incorrectly filling out the form: The form must be completed accurately and thoroughly. Missing signatures, dates, or unchecked boxes can create significant issues. It’s crucial for all required parties to review the form carefully and ensure that every section is filled out correctly.

4. Not updating the form: Circumstances and wishes can change over time. An outdated DNR Order may no longer reflect the individual’s current desires. Regular review and updates, when necessary, ensure that the documentation remains relevant and enforceable.

5. Omitting copies to relevant parties: After completing the DNR Order, copies should be distributed to key individuals, including family members, healthcare proxies, and primary care providers. Failure to distribute copies can lead to situations where the DNR Order is not readily available in an emergency, potentially leading to unwanted medical interventions.

6. Lack of communication: Beyond filling out and distributing the form, open communication about the decision not to seek resuscitation in specific circumstances is crucial. Discussing the choice with loved ones and healthcare providers ensures that everyone understands the individual's wishes, reducing confusion and distress in critical moments.

By avoiding these mistakes, individuals can help ensure that their healthcare preferences are clearly communicated and respected. Consultation with healthcare professionals, meticulous attention to the form’s details, and open conversations with loved ones about end-of-life decisions are essential steps in this meaningful process.

When preparing for end-of-life care, the importance of clarity and thorough planning cannot be overemphasized. The West Virginia Do Not Resuscitate (DNR) Order form plays a crucial role in ensuring a patient's wishes are respected regarding resuscitation efforts. However, this document is often part of a broader suite of forms and documents designed to provide comprehensive guidance on a person's preferences for medical treatments and interventions. Collectively, these documents can help ensure that healthcare providers and loved ones are fully informed and legally equipped to honor the patient's wishes.

• Advance Directive: This document allows individuals to outline their preferences for medical care in the event that they are unable to communicate their decisions. It covers a broader range of medical decisions beyond the DNR order, including the types of life-sustaining treatments one might or might not want.
• Living Will: Closely related to the Advance Directive, a

The West Virginia Do Not Resuscitate (DNR) Order form shares similarities with a living will, as both are advance directives used by individuals to communicate their wishes regarding medical treatment in situations where they are unable to make decisions for themselves. A living will typically outlines a person’s preferences in various medical scenarios, including end-of-life care, while a DNR specifically addresses the desire not to have cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest.

Similar to a medical power of attorney, the DNR Order allows individuals to assert control over their health care decisions indirectly. A medical power of attorney designates another person to make health care decisions on behalf of the individual, should they become incapacitated. Conversely, a DNR is a direct declaration of one particular medical intervention the individual does or does not want, offering a clear directive to medical personnel.

The DNR Order is akin to a POLST form (Physician Orders for Life-Sustaining Treatment), as both are medical orders intended to guide emergency medical personnel and other healthcare providers in delivering the specified care during a medical emergency. While a DNR specifically addresses CPR, a POLST encompasses a broader range of life-sustaining treatments an individual may or may not want, such as intubation or feeding tubes.

Similarly, a health care proxy is a document where individuals can designate someone to make all health care decisions for them, in case they become unable to do so. This similarity to a DNR Order lies in its function to anticipate health care decisions when the individual cannot voice their preferences, though a health care proxy applies more generally to all health care decisions, not just resuscitation.

The MOLST form (Medical Orders for Life-Sustaining Treatment) bears resemblance to the DNR Order as well. Both are designed to convey specific medical directives that are crucial during life-threatening situations. While a DNR explicitly instructs healthcare providers not to initiate CPR, MOLST forms can include a variety of instructions on different treatments based on the patient's health care preferences and conditions.

An advance directive for mental health care is another document related to a DNR Order. It allows individuals to make known their preferences concerning psychiatric treatment, in the event that they're unable to make decisions due to mental incapacity. Although focusing on mental health care decisions, it parallels the DNR’s role in preemptive medical planning and specifying treatment preferences.

The Five Wishes document, which is a comprehensive advance directive that addresses personal, spiritual, medical, and legal desires at the end of life, also shares commonalities with the DNR Order. It includes directives on pain management and comfort care, among other things, but importantly it allows for a conversation around the preference for or against CPR, similar to what is declared in a DNR.

An organ donor card, while primarily focused on posthumous decisions, indirectly relates to the notions underpinning a DNR Order. By making a decision about organ donation, an individual inherently influences certain aspects of how medical treatment might proceed in emergencies, potentially including resuscitation efforts, particularly at the end of life.

Lastly, the Patient Self-Determination Act (PSDA) information documents do not directly parallel a DNR Order in form but in spirit. They inform patients upon admission to a healthcare facility of their rights under the PSDA, including the right to create advance directives like a DNR and to refuse medical treatment. This connection underscores the fundamental principle of patient autonomy that guides both the PSDA and DNR Orders.

When completing the West Virginia Do Not Resuscitate (DNR) Order form, it's important to approach the process with care and accuracy. To guide you, here are five things you should do and five things you shouldn't do.

What You Should Do:

1. Review the form in its entirety before beginning to fill it out. This ensures you understand all the requirements and information needed.
2. Ensure that all information provided is accurate and legible. This includes patient information, medical details, and contact information.
3. Consult with a healthcare provider to thoroughly understand the implications of a DNR order. This professional guidance is invaluable.
4. Make sure the patient or their legal guardian signs the form where required. This signature is a crucial legal component of the DNR order.
5. Keep a copy of the completed form in an easily accessible place and inform close family members or caregivers of its existence and location.

What You Shouldn't Do:

1. Don't leave any sections incomplete. Each section of the form pertains to important information that needs to be fully addressed.
2. Don't guess on any information. If you're uncertain about any part of the form, it's better to seek clarification than to make assumptions.
3. Don't use unclear handwriting. If the form is handwritten, ensure that all entries are readable to avoid any confusion or misinterpretation.
4. Don't forget to date the form. The date is crucial for establishing when the DNR order was made.
5. Don't fail to review the form for errors before submitting it. Even minor mistakes can create complications regarding the DNR's validity.

Many misconceptions surround the West Virginia Do Not Resuscitate (DNR) Order form, which can lead to confusion and misunderstanding about its purpose and effect. By addressing these misconceptions, individuals can make more informed decisions regarding their health care preferences.

• Anyone can sign a DNR Order: In truth, West Virginia requires that a DNR Order must be signed by a qualified medical professional. This is usually a physician, who agrees that in the event of a cardiac or respiratory arrest, resuscitation should not be attempted. The patient or their legally authorized representative must also consent to the order.
• DNR Orders cover all forms of medical treatment: This is not accurate. A DNR Order specifically addresses the issue of not performing cardiopulmonary resuscitation (CPR) in the event of a heart stoppage or stopping breathing. It does not apply to other treatments or interventions a patient might require, such as pain management, antibiotics, or nutritional support.
• A DNR Order is only for the elderly or terminally ill: While it's true that DNR Orders are often associated with the elderly or those with terminal illnesses, they can be applicable to anyone of any age who wishes to avoid CPR in the event of a cardiac or respiratory arrest. The decision is based on personal values, beliefs, and medical advice, not just age or health status.
• Signing a DNR Order means giving up on life: This misconception couldn't be further from the truth. Many people choose a DNR Order as a way to maintain control over their end-of-life care, ensuring that their wishes are respected. It's about the quality of life rather than giving up.
• DNR Orders are permanent and cannot be changed: Actually, a DNR Order can be revised or revoked at any time by the individual for whom it was created, as long as they can communicate their wishes effectively. If they are unable to do so, a legally authorized representative can make these changes on their behalf.
• If you have a DNR Order, emergency services won't help you: Emergency medical technicians (EMTs) and other first responders are trained to provide care that respects the existence of a DNR Order but still aids in pain relief and other non-CPR-related assistance. They are obligated to provide all the necessary support within the boundaries of the DNR.
• Only a legal document can serve as a DNR Order: While a formally completed DNR Order is crucial, in West Virginia, a verbal DNR Order given to medical personnel by a physician is also valid. However, for clarity and to avoid any confusion during emergencies, a written and signed DNR Order is strongly recommended.
• DNR Orders are decided by healthcare providers: The decision to have a DNR Order must come from the individual (if capable) or their legally authorized representative, based on the individual's wishes and values. A healthcare provider's role is to provide information and to respect the patient's wishes by signing the order once it aligns with the patient's health status and goals of care.
• A DNR Order affects insurance benefits: There's a common fear that choosing a DNR Order could impact one's health insurance benefits or lead to the denial of medical treatment. This is entirely false. Decisions about DNR Orders are personal and medical, not financial. They do not influence insurance coverage or benefits.

When it comes to filling out and using the West Virginia Do Not Resuscitate (DNR) Order form, it's crucial to understand the key steps and guidelines to ensure the document reflects the patient's wishes accurately. Here is a list of important takeaways to help guide you through this process:

• Eligibility criteria must be met: The West Virginia DNR Order is designed for patients with a terminal condition, as certified by a physician, where resuscitation would not result in a meaningful, functional recovery.
• A physician's signature is required: To validate the DNR Order, a physician must review the patient's medical condition and sign the form, confirming that the patient meets the necessary criteria.
• Clear communication with family: It's essential for patients to discuss their wishes regarding resuscitation with their family members to prevent any confusion or misunderstandings in an emergency.
• Accessibility of the DNR Order: Once completed, the DNR Order should be kept in a location that is easily accessible to emergency personnel, such as beside the bed or on the refrigerator door.
• Inform healthcare providers: Ensure all healthcare providers involved in the patient's care are aware of the DNR Order and understand its implications.
• Review and renewal: Regularly review the DNR Order to ensure it still reflects the patient's current wishes and medical status. Note any changes in the patient's condition that might influence decisions about resuscitation.
• Revocation process: Understand how to revoke the DNR Order if the patient changes their mind. This typically requires a formal declaration or the physical destruction of the document.
• Legal recognition: Educate yourself about the legal status of DNR Orders in West Virginia, including any recent changes in law or healthcare policy that might affect their recognition and enforcement.
• Considerations for non-hospital settings: For patients residing in non-hospital settings, such as at home or in a nursing home, specific procedures may need to be followed to ensure the DNR Order is honored by emergency medical services (EMS).