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Survey of State EMS-DNR Laws and Protocols

Published online by Cambridge University Press:  01 January 2021

Charles P. Sabatino
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Extract

This article details the results of a national survey conducted in 1999 of statewide laws and protocols providing for the creation and recognition of donot- resuscitate (DNR) orders effective in nonhospital settings. Applicable primarily to emergency medical services (EMS) personnel, most of these laws and protocols have been in existence for less than ten years, and there is little current comparative information on them. Such policies are commonly called out-of-hospital or prehospital DNR orders, although one state-Virginia-recently amended its DNR law to establish a durable DNR order applicable to all health care providers and all settings. I will refer to the laws and policies examined here interchangeably as out-of hospital DNR protocols or EMS-DNR protocols. The survey produced a descriptive snapshot of such laws and protocols in effect on a statewide basis as of March 1999.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 27 , Issue 4 , Winter 1999 , pp. 297 - 315
Copyright
Copyright © American Society of Law, Medicine and Ethics 1999

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References

See 1999 Va. Acts ch. 814 (amended Mar. 29, 1999).Google Scholar
The term prehospital DNR, although common, is not used here because these protocols apply just as well at the posthospital stage and during transfers between health facilities.Google Scholar
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These include Delaware, District of Columbia, Iowa, Mississippi, Nebraska, North Dakota, Pennsylvania, South Dakota, and Vermont.Google Scholar
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They include Alabama, Nevada, New Hampshire, Rhode Island, and Wyoming. In Louisiana, an individual must complete a health care declaration (living will) and register it with the secretary of state to receive a DNR identification bracelet.Google Scholar
They include Illinois, Michigan, Minnesota, Missouri, North Carolina, Oklahoma, Oregon, South Carolina, and Tennessee.Google Scholar
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They include Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Idaho, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Montana, Nevada, New York, Ohio, Oklahoma, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.Google Scholar
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They include Arizona, California, Colorado, Indiana, Kansas, Kentucky, Maryland, New York, Oklahoma, South Carolina, Texas, Utah, West Virginia, and Wyoming.Google Scholar
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The provider must have no “knowledge that the action or decision would be inconsistent with a health care decision that the individual signing the request would have made on his or her own behalf under like circumstances.” Cal. Prob. Code § 4753(a) (West 1999).Google Scholar
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They include Arkansas, Colorado, Illinois, Maine, Massachusetts, Mississippi, Montana, Nevada, New Hampshire, Ohio, Oregon, South Carolina, Utah, Virginia, Wisconsin, and Wyoming.Google Scholar
They include Arizona, Colorado, Florida, Kansas, Nevada, New Mexico, Oregon, Texas, and Virginia.Google Scholar
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6 Colo. Code Regs. § 1015-2-3.5(c) (1998) (“Rules Pertaining to Implementation and Application of Advance Medical Directives for Cardiopulmonary Resuscitation (CPR) By Emergency Medical Service Personnel”).Google Scholar
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