Survey of State EMS-DNR Laws and Protocols

Author:

Sabatino Charles P.

Abstract

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.

Publisher

Cambridge University Press (CUP)

Subject

Health Policy,General Medicine,Issues, ethics and legal aspects

Reference120 articles.

1. 9. See Cruzan v. Director, Missouri Department of Health , 497 U.S. 261 (1990).

2. 52. See, for example, Ga. Code Ann. § 31-39-7(b)(1) (1998) (“…reasonably and in good faith was unaware of the issuance of an order not to resuscitate…”).

3. 2. 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.

4. 69. They include Arizona, Colorado, Florida, Kansas, Nevada, New Mexico, Oregon, Texas, and Virginia.

5. 51. See, for example, Idaho Code § 39.159(1)(d) (1998) (no liability for providing “life-sustaining procedures pursuant to an oral or written revocation…”).

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