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RobertJDFL, Attorney
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Does a signed DNR paper on a patiant have to be signed by a

Customer Question

Does a signed DNR paper on a patiant have to be signed by a doctor in south carolina?
Submitted: 6 years ago.
Category: Legal
Expert:  RobertJDFL replied 6 years ago.
Thank you for your question.

Yes, it must be signed by someone licensed to practice medicine or osteopathy within the state. Here is the statue:

SECTION 44-78-15. Definitions.

As used in this chapter:

(1) "Do not resuscitate order for emergency services" means a document made in accordance with this article to prevent EMS personnel from employing resuscitative measures or any other medical process that would only extend the patient's suffering with no viable medical reason to perform the procedure;

(2) "EMS personnel" means emergency medical personnel certified by the South Carolina Department of Health and Environmental Control, and for purposes of this chapter, "EMS personnel" includes first responders who have completed a Department of Health and Environmental Control approved medical first responder program;

(3) "Health care provider" means a person licensed to practice medicine or osteopathy pursuant to Title 40, Chapter 47;

(4) "Palliative treatment" means the degree of treatment which must be provided to a patient in the routine delivery of emergency medical services, which assures the comfort and alleviation of pain and suffering to all extents possible, regardless of whether the patient has executed a document as provided for in this chapter;

(5) "Resuscitative treatment" means artificial stimulation of the cardiopulmonary systems of the human body, through either electrical, mechanical, or manual means including, but not limited to, cardiopulmonary resuscitation;

(6) "Terminal condition" means an incurable or irreversible condition that within reasonable medical judgment could cause death within a reasonably short period of time if life sustaining procedures are not used.


SECTION 44-78-20. Terminal patient may request health care provider to execute "do not resuscitate order for emergency services"; conditions.


A patient who has a terminal condition or a surrogate for a patient with a terminal condition under the Adult Health Care Consent Act or an agent of a person with a terminal condition named by the patient in a Health Care Power of Attorney may request a health care provider responsible for the care of the patient to execute a "do not resuscitate order for emergency services" if the following conditions apply:

(1) the patient has a terminal condition;

(2) the terminal condition has been diagnosed by a health care provider and the health care provider's record establishes the time, date, and medical condition which gives rise to the diagnosis of a terminal condition.

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Customer: replied 6 years ago.
Patiant was in nursing home with a living will not to be resucetated and signed DNR and nurse said she would get doctor to sign DNR when he came through that night. The next morning she got a call from nursing home that her dad was none responsive and hung up. thinking her dad was dead she started crying .Thirty minutes later she received a call back saying the EMS had got a pulse and he was on his way to the hospital where he ended up in CCU on a venterlator with six IVs in him convulsing at every breath. He had alzheimers ,broken ribs ,punctured lung and a staff infection he got from being in the hospital prior to coming to the nursing home.Then the decision had to be made to unplug him which was very painful to all.
Expert:  RobertJDFL replied 6 years ago.
So it sounds like the DNR was never signed then? If that is the case, the nursing home may have some liability for ignoring the requests of his guardian (I presume it was his daughter who requested the DNR).

If the DNR had been signed, and was just ignored, then the liability extends to everyone who knew the DNR was in place but ignored it -EMS, the hospital, etc.

However, as you can see from the statute, in order for a doctor to sign a DNR, a patient must have a terminable condition, meaning an incurable or irreversible condition that within reasonable medical judgment could cause death within a reasonably short period of time if life sustaining procedures are not used. Alzheimer's Disease, by itself would not fall under the definition of a terminal condition because a person can live for years with it. It's not clear from your facts if the woman's father was in fact terminal which lead to the nurse stating she would have a doctor execute the DNR.
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Customer: replied 6 years ago.
whats the purpose of having a living will if your spouse or child can't sign the DNR if the patiant who is not terminal does not want to be revived?
Expert:  RobertJDFL replied 6 years ago.
Both living wills and DNR orders deal with end-of-life decisions, but they are different. You may complete a living will document yourself even when you are healthy. Your living will document specifies in advance the kind of medical treatment you would want if and when you have a terminal illness or are in a permanently unconscious state and are no longer able to state your own wishes.

By contrast, you do not write a DNR order for yourself. Instead, you make your wishes known to your physician, who writes a DNR order if and when your condition warrants it. The DNR order addresses your current state of health and the kind of medical treatment you and your physician decide is appropriate under current circumstances.

Generally, a DNR order will also only deal with no use of CPR, whereas a living will goes much further, and provides that a person, if deemed terminal should not have various treatments of their choosing (for example, some people want no amputations done, others want no food and water, just pain medication, others want just hydration and pain medication, etc).

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