In our previous edition of McDowall News we explained what an Advance Health Care Directive is. In this edition we will talk about what is not an Advance Health Care Directive. Speci cally, we will discuss DNR’s and POLST’s.

What is not an Advance Health Care Directive?

Often times, individuals will confuse an Advance Health Care Directive with the Physician Orders for Life Sustaining Treatment (POLST) form or a pre-hospital Do Not Resuscitate Order (DNR).

Because of its color, the POLST is often referred to as the “Pink Form.” It complements, but does notreplace, an Advance Health Care Directive. The POLST is completed and signed by the patient and the patient’s physician. If the patient is not able to sign the POLST, it may be signed by the patient’s agent on behalf of the patient. The directions on the POLST may include a pre-hospitalization DNR Order. It also contains additional instructions selected by the patient for other medical interventions. Once at the hospital, a patient will be assessed by a physician who will issue appropriate orders.

A pre-hospital DNR Order is properly titled an “Emergency Medical Services Prehospital Do Not Resuscitate Form.” It is an of cial state document which instructs medical professionals to forego pre- hospital resuscitation. Thus, if an individual with a DNR stops breathing and emergency personnel are summoned, the emergency personnel are to forego attempts at resuscitation if they have con rmation of the DNR. The DNR form needs to be signed by a physician and readily accessible when Emergency Medical Assistance arrives.

As you can appreciate, while Advance Health Care Directives are for everybody over 18 years of age, a POLST or DNR is generally for those individuals who are aged and/or suffer from a severe medical condition such that resuscitation is not desired. If an individual completes a POLST or DNR, the use of a bracelet con rming the existence of the patient’s desires and the display of the copy of the form will help to ensure that the patient’s wishes will be honored.

In summary, all competent adults—that is everyone in California over 18 who is competent—should complete an Advance Health Care Directive. Whether an individual will complete a POLST or a pre- hospitalization DNR Order is a decision for the patient and the patient’s physician and is determined based on the patient’s circumstances and desires.

If you have questions regarding Advance Health Care Directives, POLST’s or DNR’s please feel free to contact our of ce. You can obtain a blank Advance Health Care Directive by going to our website at www., double click on “Resources” then double click on “Tools”. POLST forms may be obtained from your physician or ordered from the POLST Task Force at A DNR form, which directs only pre-hospitalization personnel, can be obtained by going to the California Emergency Medical Services Authority at Click on the link for the DNR form and then select a PDF of the form identified at the top of the list of available forms. Once you have completed a POLST or a DNR, a DNR bracelet can be obtained through MedicAlert Foundation or Caring Advocates. MedicAlert can be reached at 888-755-1448 and its website is Caring Advocates can be reached at 1-800- 647-3223 and its website is

-Robert Vale, Esq.

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