Bleu,

You really got me thinking about all this and brought up something I had not thought about. In light of the first paragraph of my previous post, after reading your reply, I just read about 10 different sources on DNR's and further information on living wills, advanced directives and powers of attorney. Without the others, it looks it is pretty standard to obtain a signature from your "attending" physician and two witnesses, who are not your family doctor or health care facility employees is usually required for just a DNR alone.

Since I have never persued just a out- of- hospital DNR alone, my wishes on that are included in my Advanced Directive, Living Will and Power of Attorney contained in my will. That did not require a physician's signature to be legal. These documents have covered every situation I could think of that may come up, including organ donation. Documenting my wishes in all my doctors charts, most of whom would probably never be involved in a DNR situation, helps me feel there is no question about my wishes whether or not they agree or would consent to signing a DNR. Although that might not be legal, under the HIPAA laws I do have the right to include that in my chart. At least any of those caregivers could make my wishes known to an attending physician, in the absence of the legal documents or my family while they were being found.

Since DNR's pretain to withholding of treatment for cardiac or respiratory arrest, this situation is usually something that comes up in light of a serious illness where you could request a in-hospital DNR by the doctor or facility treating you for that illness, which it seems would require signatures at that time. It seems pretty standard and the treating doctor can defer to another if they to not agree including moral or legal issues.

I think everyone does need to find out exactly what the laws are on all these documents, because I just read differences in a number of states, some completely opposite from others. Since I just redid my will, I really can only speak for the laws in my own state.

I read that places like OH and the Cleveland Clinic have different types of DNR's with either comfort care, comfort care arrest and specified. Also, if there is a conflict between DNR's and AD's and LW's, there are precedents of one over another, but again that may differ among the states.

Over all, it does seem like the best way to insure your wishes about DNR's out-of-hospital is through these other legal documents. In the midst of a serious or fatal illness, it does not seem necessary and a pretty standard procedure. To insure your wishes in such a situation, a durable power of attorney allows others to make decisions on your behalf if you are unconscious which could always become a possibility as well and without your legal consent in these other documents, it could become a battle of wills among family members.

The thing you mentioned I hadn't thought of was in the case of EMS providers. Without the papers or a DNR braclet or necklace, they are legally obligated to treat you. But unless one is seriously ill, I don't know anyone who goes around wearing these things or keeps a copy of these signed forms on there person. If I was in a car accident and brain dead, they wouldn't know that at the time and because they can't know they certainly should do everything to save my life. So I am assuming, if say artificial resperation is initiated by the EMS, and it is determined at the hospital I was brain dead, these other legal forms would justify the discontinuance of that or any further treatment including CPR.

For me, all these documents are a must if I want my wishes carried out and keep from putting such burdens of decision on my family.

Bleu, you and your situation are still the topic of this thread and I am proud of you for calling your doctor about seeing him sooner. I take it you have to make appt directly with him, vs. and office staff. I hope this all works out for you with him and I think it will if he truly cares about you. If he doesn't, then better to find that out now. Good Luck with this and your DRN, let us know how it goes.