DO NOT RESUSCITATE (DNR)

DO NOT RESUSCITATE (DNR)



The Office of the State Guardian (OSG) utilizes a form to ascertain that Illinois law is upheld when a guardian or physician is recommending a Do Not Resuscitate (DNR) order for a disabled ward of the court. This document may be viewed at:

http://www.gac.state.il.us/pdfs/DNRForm.pdf



The following are excerpts from this form:



This form was designed to make obtaining a DNR order or making decisions to withhold or withdraw treatment for a ward of the Office of State Guaardian as simple as pollsible. All of the information requested is required to comply with the IL Health Care Surrogate Act (HCSA). The Office of the State Guardian can only provide consent for wards who are unable to make decisions for themselves, and only when the requirements of the HCSA are met.

This completed form will be reviewed by an OSG guardianship representative who will visit the ward and contact all known family or friends.

An attending physician, as well as a second medical opinion ( a concurring physician) must also complete the form.

Questions on the form include the decision making capability of the ward, if a DNR order withholding all resuscitation efforts is recommended; the medical condition in support of consent request; other treatment options; what does the physician feel will cause the patient's death; hospice consideration; and a question regarding ethics which reads: Has an ethics committee reviewed this case?

Qualifying conditions for DNR: Terminal Condition; Permanent Unconsciousness; Incurable or irreversible condition


A second medical opinion is required, and that physician must have examined the ward within the last 24 hours. The physician must sign a statement that he/she concurs that the patient lacks the ability to understand and appreciate the nature and consequences of decisions regarding the foregoing of life-sustaining treatment, and that the ward lacks the ability to reach and communicate an informed decision. I also concur that this request for the withholding and/or withdrawing of treatment is appropriate and warranted due to the nature of this patient's condition. I have also documented these conclusion in the patient's medical chart.

Editor's note: Kudos to the Office of the State Guardian for assuring the law is upheld when making decisions which may result in the end of the ward's life. Unfortunately, we have heard of many cases involving private guardians in the Cook County Probate Court that do not follow the law, and wards are given a DNR status and admitted to hospice in an illegal manner. One can't help but wonder why a private guardian would choose to ignore the DNR laws in the State of Illinois. WHY??