Our Skilled NYC Estate Planning Attorneys Explain What a DNR Order Can and Can’t Do
A do-not-resuscitate (DNR) order is a patient’s written request not to be revived if they stop breathing or their heart stops beating. You can have a DNR drafted when you’re still in good health or provide instructions for a family member in the event that you’re ever incapacitated. 
DNRs typically require a medical professional’s signature to take effect, but they aren’t always legally binding—and they tend to work best only when they’re part of a broader, more comprehensive estate plan. The experienced estate planning lawyers at Landskind & Ricaforte Law Group P.C. explain what you can accomplish with a DNR order.
Using a DNR Order to Ensure Your Preferences Are Honored
If somebody is seriously injured in an accident or loses consciousness due to a terminal medical condition, doctors will usually take reasonable steps to ensure that their patient does not pass away. In emergency settings, life-saving measures often take the form of “cardiopulmonary resuscitation” (CPR).
Resuscitation typically involves any combination of the following:
- Mouth-to-mouth breathing
- Chest compressions
- Electric shocks to try and restart the heart
- Intubation
- Prescription medications
However, resuscitation can be painful, and even when it succeeds in prolonging a patient’s life, it may come at the cost of their physical well-being or personal sense of independence. A DNR averts all uncertainty by asking doctors to step aside and let life, or death, take its course.
Reasons You May Want a DNR Order
People prepare, request, and authorize DNR orders for many different reasons. Some of the most common relate to:
- Personal beliefs. Many religions and religious sects have rules about resuscitation. Drafting and executing a DNR order helps ensure that your beliefs take precedence over a hospital’s standard procedures.
- Poor health. People who have been diagnosed with a terminal illness often wish to die on their own terms. DNR orders are an opportunity to decide for yourself when “enough is enough.”
- Probability of recovery. Older adults, as well as some people with chronic health conditions, may feel that their chances of recovering from a serious accident or incapacitating illness are not high enough to justify the risks of resuscitation.
New York’s Legal Requirements for DNR Orders
In New York, state law instructs hospitals to presume that patients consent to CPR in the event of cardiac or respiratory arrest. DNR orders will only be considered valid if they meet any one or more of the following conditions:
- You have already authorized and executed a DNR order
- Your estate plan has nominated a health care agent who is authorized to make decisions about your treatment
If you do not have an existing DNR order or a living will, your doctor may not be able to issue a DNR order unless they can locate a “surrogate.” In most cases, a surrogate is a close living relative, such as a spouse, son, or daughter.
Surrogates can authorize DNRs, provided that one of the following is true:
- You have a terminal medical condition
- You are permanently unconscious
- Your doctors believe that CPR would serve no medical purpose
- Your doctors believe that CPR would worsen your condition and detract from your quality of life
However, even if your family members can agree on who should serve as a surrogate, your on-the-spot representative may not have all the information—or the willpower—needed to make a decision that respects your preferences.
A DNR Order and Your Estate Plan
In New York, doctors have a moral and legal obligation to respect patients’ DNR orders. If a physician doesn’t agree with your decision to let go, they’re required to transfer you to the care of another medical professional who won’t object.
Nevertheless, DNR orders aren’t without limitations. Even if you’ve had a doctor or nurse sign off on your order, you could run into trouble with the following:
- Review periods. You can’t sign a DNR order and expect it to remain in place indefinitely. Under state law, a DNR order is only valid if you sit down with your physician to review its terms every 90 days. If you miss an appointment, your preferences won’t be renewed.
- EMS. Your DNR order is only binding in the context of your stay in a hospital or other medical facility. However, if you’re seriously injured in an accident, emergency services personnel have no obligation to honor your DNR order—and will, in many cases, refuse to consider its terms.
- Your estate plan. If you have a living will, an advance care directive, or other estate planning provisions that could come into conflict with your DNR order, there’s no guarantee that it will survive a court contest.