DNR stands for Do-Not-Resuscitate. This document shows a patient’s will to exercise their right to reject resuscitation and die a natural death due to an accident, illness, or old age. When a person chooses to reject such medical help, they need a legal document to make that possible. In the United States, this document is called a DNR Order.
Each state has its form of DNR order. The forms differ in structures and sign requirements. However, the core of such documents is always the same: they provide patients with the right to reject resuscitation treatment, including the following set of procedures:
In each state, DNR programs are regulated by different administrative rules and laws. In Virginia, the DNR program is subject to regulation by § 54.1-2987.1 of the Code of Virginia. To sign a DNR form in Virginia, you will need a patient and a physician.
The Virginia DNR Order Form is a five-page document. The first two pages contain general information about the DNR form.
The sections include:
The form itself starts on page 3—that’s where a patient and their physician should go to fill out the form. The two must fill out two subsequent pages that contain identical information.
It is necessary because each page—starting with page 3—has its purpose:
A patient and a physician fill out the pages of the Virginia DNR form.
1. Provide the Patient’s Personal Information
First, the patient writes down their full name and puts down the date of signing.
2. Have a Physician Specify the Patient’s Health Status
Then, the physician must check one of the two boxes to specify if the patient can make decisions or is not capable of doing so.
Suppose the patient is not capable of making decisions regarding their health and life. In that case, the physician must check one of three boxes in the next section to specify if the patient—while being capable of making decisions—has either executed an advanced directive to reject CPR or has appointed a legal representative to act on their behalf, or has never done any of that. If they have not, the DNR form should be signed by a person authorized to act on the patient’s behalf.
3. Make the Patient and the Physician Affix Their Signatures
On the bottom part of the page, the patient and the physician must put down their signatures.
The physician must also input their printed name and emergency phone number.