Do Not Resuscitate Orders (DNRs)

Georgia law (O.C.G.A. § 31-39-1 et seq.) defines a candidate for non-resuscitation as a patient who, based on a determination to a reasonable degree of medical certainty by an attending physician with the concurrence of another physician:

(A) Has a medical condition which can reasonably be expected to result in the imminent death of the patient;

(B) Is in a noncognitive state with no reasonable possibility of regaining cognitive functions; or

(C) Is a person for whom cardiopulmonary resuscitation would be medically futile in that such resuscitation will likely be unsuccessful in restoring cardiac and respiratory function or will only restore cardiac and respiratory function for a brief period of time so that the patient will likely experience repeated need for cardiopulmonary resuscitation over a short period of time or that such resuscitation would be otherwise medically futile.

Generally, every patient is presumed to have capacity to consent, and is presumed to consent, to cardiopulmonary resuscitation in the event of cardiac or respiratory arrest, unless there is consent or authorization for the issuance of an order not to resuscitate. O.C.G.A. § 31-39-3(a). Consent does not presume administration of CPR because it is not required if it would be futile.

Any written order issued by the attending physician using the term “do not resuscitate,” “DNR,” “order not to resuscitate,” “do not attempt resuscitation,” “DNAR,” “no code,” “allow natural death,” “AND,” “order to allow natural death,” or substantially similar language in the patient’s chart shall constitute a legally sufficient order and shall authorize a physician, health care professional, nurse, physician assistant, caregiver, or emergency medical technician to withhold or withdraw cardiopulmonary resuscitation. Such an order shall remain effective, whether or not the patient is receiving treatment from or is a resident of a health care facility, until the order is canceled as provided in Code Section 31-39-5 or until consent for such order is revoked as provided in Code Section 31-39-6, whichever occurs earlier. An attending physician who has issued such an order and who transfers care of the patient to another physician shall inform the receiving physician and the health care facility, if applicable, of the order.

An adult may consent to a DNR for himself or herself, and an authorized person may also consent. Authorized persons, in order of priority, are: (a) Any agent under a durable power of attorney for health care or health care agent under an advance directive for health care appointed pursuant to Chapter 32 of this title; (b) A spouse; (c) A guardian over the person appointed pursuant to the provisions of Code Section 29-4-1; (d) A son or daughter 18 years of age or older; (e) A parent; or (f) A brother or sister 18 years of age or older. Where such authorized person is an agent under a durable power of attorney for health care or a health care agent under an advance directive for health care appointed pursuant to Chapter 32 of this title or where a Physician Orders for Life-Sustaining Treatment form with a code status of “do not resuscitate” or its equivalent has been executed in accordance with Code Section 31-1-14 by an authorized person who is an agent under a durable power of attorney for health care or a health care agent under an advance directive for health care appointed pursuant to Chapter 32 of this title, the attending physician may issue an order not to resuscitate a candidate for non-resuscitation pursuant to the requirements of this chapter without the concurrence of another physician, notwithstanding the provisions of paragraph (4) of Code Section 31-39-2.

The DNR statute does not impair or supersede any legal right to withhold or withdraw treatment, if done so lawfully. Also, it does not impair or prevent any court’s authority to issue an order not to resuscitate.