The Difference Between A Do Not Resuscitate (DNR) and Living Will?


I once had a client come in and tell me that the Living Will that their mother had didn’t work because she “coded” in the hospital and they revived her in direct contradiction to the Living Will.  I had to explain to them that a Living Will is NOT a DNR.  If their mother didn’t have a DNR, the hospital was obligated to revive her.  Then if the doctors determined that there was no reasonable medical probability of recovery from her state after being revived, the Living Will would require that no “heroic measures” or health care to artificially prolong life could be administered.  To be blunt a DNR is a “leave them where they lie” order and a Living Will is an “unplug them” order.

Here’s what the difference is for me and you.

All people, even an 18 year old, should have a Living Will.  Terri Ann Schivo was 28 years old when she had a catastrophic heart attack and ended up in a persistent vegetative state for over 10 years.  There was nothing that could be done for her – no reasonable medical probability of recovery.  She was kept alive through a feeding tube.  That feeding tube was an artificially life prolonging measure.  If she had had a Living Will, after it was clear that she was no longer going to recover, her husband could have had the feeding tube removed and Terri would be allowed to die.  Maybe you remember the 1.3 Million Dollar fight over whether that should happen or not.  But Terri didn’t have a Living Will.

Terri also didn’t have a DNR, but why would she?  She was 28 years old and not expecting to have these problems.  I have 50 year olds who come into my office and say I want a DNR.  I tell them they are crazy.  If they have a heart attack or respiratory arrest, they could be revived and live another 25 years!  They say, I don’t care . . . I want a DNR.  Luckily I can honestly tell them that they have to have their doctor give them one.  DNR’s have to be signed by your physician and have to be on yellow paper to be valid.  If your doctor agrees that you are old and/or infirmed enough that it might be cruel to revive you, then he will sign a DNR.  The yellow paper is so that the Emergency Medical Team that is there to work on you, either the ambulance that arrived at your house or in the hospital, can see that it is a DNR and be assured that you don’t want to be revived.

A Living Will is a document where you, yourself, now in the present, say that “in the future” if I cannot express my wishes, and I have a condition that my doctors do not believe I have any probability of recovering from, then I want comfort care only.  Dying with dignity as it is often referred to.  Most of my clients want some form of that.

You should speak with an attorney about this if you want to make sure that you don’t end up on machines at the end of your life while the health care dollar meter keeps ticking on!