Attorney-Approved Do Not Resuscitate Order Document for Michigan
Table of Contents
In Michigan, the Do Not Resuscitate (DNR) Order form serves as a critical document for individuals who wish to express their preferences regarding medical treatment in the event of a cardiac or respiratory arrest. This form is designed to ensure that a person's wishes are respected when they are unable to communicate them. It outlines specific instructions to healthcare providers, indicating that the individual does not want to receive cardiopulmonary resuscitation (CPR) or other life-saving measures in such emergencies. The DNR Order must be completed and signed by both the patient and a physician, establishing a legal basis for healthcare professionals to honor these wishes. Additionally, it is important for individuals to discuss their decisions with family members and healthcare proxies, as this can facilitate understanding and support during challenging times. The form can be easily recognized by its distinctive color and is intended to be kept in a visible location, ensuring that it is readily accessible when needed. Understanding the implications of the DNR Order and the process for completing it is essential for anyone considering this important aspect of end-of-life care.
Documents used along the form
The Michigan Do Not Resuscitate Order (DNR) form is an important document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. It is often used alongside other forms and documents to ensure that a person's healthcare preferences are clearly understood and respected. Below is a list of related documents that may be utilized in conjunction with the DNR form.
- Advance Directive: This document outlines a person's healthcare preferences and appoints a healthcare proxy to make decisions on their behalf if they become unable to communicate.
- Durable Power of Attorney for Healthcare: This legal document designates a specific individual to make medical decisions for someone if they are incapacitated.
- Living Will: A living will specifies the types of medical treatment an individual wishes to receive or avoid, particularly in end-of-life situations.
- Texas Durable Power of Attorney form: This important document allows a designated individual to make decisions on your behalf if you're unable to do so, ensuring your wishes are respected. For more information and to access a template, visit https://txtemplate.com/durable-power-of-attorney-pdf-template/.
- Physician Orders for Life-Sustaining Treatment (POLST): This form translates a patient’s wishes regarding treatment into actionable medical orders for healthcare providers.
- Health Care Proxy Form: This document allows an individual to appoint someone to make healthcare decisions on their behalf when they are unable to do so.
- Do Not Intubate (DNI) Order: Similar to a DNR, this order specifically instructs healthcare providers not to insert a breathing tube in case of respiratory failure.
- Patient Information Form: This form collects essential medical history and preferences, ensuring that healthcare providers have a comprehensive understanding of the patient's needs.
- Medication Administration Record: This document tracks the medications prescribed to a patient and is crucial for ensuring that their treatment plan aligns with their wishes.
Utilizing these documents in conjunction with the Michigan Do Not Resuscitate Order helps to create a clear and comprehensive plan for medical care. It is essential to ensure that all healthcare preferences are documented and easily accessible to healthcare providers and loved ones.
Discover Some Other Do Not Resuscitate Order Templates for Specific States
Out of Hospital Dnr Indiana - Families often find it helpful to review DNR orders periodically.
Dnr Comfort Care - This directive is recognized in most states, often with specific legal requirements.
The California DV 260 form is essential for individuals seeking protection through a restraining order, as it provides crucial information to law enforcement while maintaining confidentiality. For those looking to complete this important document, resources are available, including California PDF Forms, which can guide you through the process effectively.
Illinois Do Not Resuscitate Law - A DNR order should be signed by the person or their legally authorized representative.
Michigan Do Not Resuscitate Order Example
Michigan Do Not Resuscitate Order
This Do Not Resuscitate (DNR) Order is established pursuant to Michigan law, specifically the Michigan Compiled Laws, Act 193 of 1994. This document allows a person to refuse resuscitation measures in the event of a medical emergency.
It is crucial to complete this form accurately to ensure it reflects your wishes regarding resuscitation efforts.
Patient Information:
- Name: _____________________________
- Date of Birth: ______________________
- Address: ____________________________
Physician Information:
- Physician's Name: ____________________
- Contact Number: _____________________
- Medical License Number: ______________
Advanced Directives:
- The patient does not wish to receive cardiopulmonary resuscitation (CPR) in the event of a cardiac arrest.
- This order is effective immediately upon the date of signing.
- This document must be signed by the patient or their legal representative and the physician.
Signatures:
- Patient's Signature: ______________________ Date: _______________
- Legal Representative's Signature (if applicable): ______________________ Date: _______________
- Physician's Signature: ______________________ Date: _______________
This Do Not Resuscitate Order should be kept in a prominent location and communicated to all healthcare providers involved in the patient's care.
FAQ
What is a Michigan Do Not Resuscitate (DNR) Order?
A Michigan Do Not Resuscitate Order is a legal document that allows a patient to refuse certain life-saving medical interventions, specifically cardiopulmonary resuscitation (CPR), in the event of cardiac or respiratory arrest. This order is meant for individuals who have a terminal condition or are experiencing a severe decline in health. By completing this form, patients can ensure their wishes regarding end-of-life care are respected by medical professionals.
Who can complete a DNR Order in Michigan?
In Michigan, a DNR Order can be completed by individuals who are at least 18 years old and are capable of making their own medical decisions. If a patient is unable to complete the form themselves, a legally authorized representative, such as a family member or guardian, may do so on their behalf. It is important that the individual understands the implications of the DNR Order and has discussed their wishes with their healthcare provider.
How do I obtain a Michigan DNR Order form?
You can obtain a Michigan DNR Order form through various channels:
- Visit the Michigan Department of Health and Human Services (MDHHS) website, where the form is available for download.
- Contact your healthcare provider or hospital, as they often have copies of the form readily available.
- Request the form from local health departments or senior care facilities.
Once you have the form, it is crucial to fill it out correctly and have it signed by your physician to ensure it is valid.
What should I do after completing the DNR Order?
After completing the DNR Order, follow these steps to ensure your wishes are communicated effectively:
- Make several copies of the signed form. Keep one in a safe but accessible place at home.
- Provide copies to your healthcare provider, family members, and any caregivers involved in your care.
- Consider placing a copy in a visible location, such as on your refrigerator, to ensure emergency responders are aware of your wishes.
Regularly review and update the DNR Order as needed, especially if your health status or preferences change.
Key takeaways
Understanding the Michigan Do Not Resuscitate Order (DNR) form is crucial for anyone considering end-of-life care options. Here are key takeaways to keep in mind:
- The DNR form must be signed by a physician to be valid.
- It is essential to have the patient's consent before completing the form.
- The form should clearly state the patient's wishes regarding resuscitation.
- Keep copies of the signed DNR form in easily accessible locations.
- Inform family members and healthcare providers about the existence of the DNR order.
- Review the DNR order regularly to ensure it reflects current wishes.
- The DNR form is only applicable in emergency situations.
- In Michigan, a DNR order does not affect other medical treatments.
- Patients can revoke the DNR order at any time, verbally or in writing.
- Always consult with a healthcare professional if there are questions about the form or its implications.
Acting promptly to complete and distribute the DNR form can provide peace of mind and ensure that healthcare wishes are respected.
PDF Form Breakdown
| Fact Name | Description |
|---|---|
| Purpose | The Michigan Do Not Resuscitate (DNR) Order form allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. |
| Governing Law | This form is governed by the Michigan Public Health Code, specifically Act 368 of 1978, as amended. |
| Eligibility | Any adult individual can complete a DNR Order. Minors require consent from a parent or legal guardian. |
| Signature Requirement | The form must be signed by the individual or their legal representative to be valid. |
| Healthcare Provider's Role | Healthcare providers must honor the DNR Order once it is properly executed and presented. |
| Revocation | A DNR Order can be revoked at any time by the individual or their legal representative, either verbally or in writing. |
| Availability | The Michigan DNR Order form is available through healthcare providers, hospitals, and online resources. |