Do Not ResuscitateIn this report I will explain what the DNR means for us as patients and healthcare professionals. I will analyze the “varying approaches to identification devices, medical prerequisites, surrogate authority, revocation, reciprocity, and the interrelationship of DNR orders with other types of advance directives” (Ladwig, n.d. pg 34 par 8) between states and hospitals in order to identify legal areas that appear to be confusing due to their differences in advance directives. Last but not least, I will look at ways to improve the confusion/differences at the national level. Do not resuscitate, or DNR, is a legal order given by a patient stating that he or she should not be resuscitated with CPR or advanced cardiac life support. If they stop breathing or their heart stops beating they have the legal right to say no to life-saving measures. The patient can have this legal form in advance or can receive one from the hospital (US National Library of Medicine, 2014). Healthcare facilities will honor the patient's wish as long as the paper work is legitimate with signatures and witnesses or whatever is required by their state. However, the DNR is often requested by the patient himself; in some cases they may be requested by the healthcare professional who has the power of attorney (US National Library of Medicine, 2014). Hospitals have had a mandate to honor their patients' decisions since 1991, when Congress passed the Patient Self-Determination Act. Forty-nine states, except my home state of Missouri, have given permission for next of kin to make decisions for inconsistent relatives. Missouri also has an additional requirement for its living will statute and that is any form... middle of paper... family calls 911 will continue to follow advanced life support protocol even if the patient is terminally ill and on hospice unless the correct DNA form is submitted by the patient or person with power of attorney (Hospice Patients Alliance, 2014). Anesthesiologists are the ones that patients who have active DNR orders encounter quite often. 15% of patients with do not resuscitate orders go to the operating room for procedures that are in most cases aimed at improving quality of life (Kelley, 2014). A do not resuscitate order for patients undergoing emergency surgery is an “independent risk factor for poor surgical outcomes and postoperative mortality” (Kelley, 2014 pg 1 para 3) and the likelihood of returning patients to functioning level precedent is higher for CPR performed during the perioperative period (Kelley , 2014).