Georgia's law on cardiopulmonary resuscitation (CPR) [July 2009]

GEORGIA'S LAW ON CARDIOPULMONARY RESUSCITATION
(CPR)
There are often many questions about who has the authority to approve orders not to resuscitate a person or to approve a "No Code." The law in Georgia is very specific and there are circumstances when regardless of a person's wishes, that order may not be carried out in the person's current physical location.
This document will attempt to clarify and simplify some of those points. It is not to be taken as legal advice and it is not intended as information o be applied outside of the State of Georgia since each state's laws differ.
This is a subject matter that should be discussed with a physician in order to clearly understandthe patient's medical condition and whether or not all the criteria have been satisfied to have his or her preferences regardinq cardiopulmonary resuscitation met.
For questions, contact the State Legal Services Developer at (404) 657-5328, or the Georgia
Senior Legal Hotline at (404) 657-9915 / 1-888-257-9519.
This information is not to be considered as legal advice. It is merely educational information made available by the Georgia Department of Human Resources Division of Aging Services. For specific legal advice, please consult your own attorney. For medical advice, please consult a licensed physician.
For additional copies of this information, call (404) 657-531911-866-55AGING or write to "Information" Georgia Department of Human Resources Division of Aging Services, 2 Peachtree Street, NW, Suite 9.398, Atlanta, Georgia 30303-3142.

U U M A N RESOURCES

Revised July 2009

CARDIOPULMONARY RESUSCITATION O.C.G.A. 531-39-1et. seq.
Definitions: CPR- measures used to restore or support cardiac or respiratory function in the event of cardiac or respiratory arrest.
Candidate for Non-CPR: 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 CPR would be medically futile in that such resuscitate will likely be unsuccessful in restoring cardiac and respiratory function or will only restore cardiac and respiratory function for a brief period of time sot that the patient will likely experience repeated need for CPR over a short period of time so that such resuscitation would be otherwise medically futile.
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Other Names for Cardio~ulmonarvResuscitation Orders surrounding the administration of cardiopulmonary resuscitation
(CPR) are recognized by a number of names:
DNR Do Not Resuscitate Order Not to Resuscitate No Code
NOTE
Under the law, the only people authorized to withhold or withdraw cardiopulmonary resuscitation are physicians, health care professionals, or emergency medical technician.

Every adult is presumed to have the capacity to make a decision regarding CPR and every patient shall be presumed to consent to the administration of CPR unless there is consent or authorization for the issuance of an order not to resuscitate.
Persons authorized to issue or consent to an order not to resuscitate:
attending physician may issue an order which authorizes a physician, health care professional, or emergency medical technician to withhold or withdraw CPR an adult person with decision making capacity (even if capacity is lost in the future) may consent orally or in writing to an order; when an agent under a durable power of attorney for health care or an advance directive for healthcare consents on behalf of the adult person, an attending physician does not need a concurring physician to issue an order not to resuscitate; Other appropriate authorized persons who may consent as long as the
adult person meets all the criteria of a "candidate for nonresuscitation":
spouse; guardian; son or daughter 18 years of age or older; parent; brother or sister 18 years of age or older; parent for a minor child, unless the child is deemed mature enough by the physician to understand the order; as a last resort, if none of the above is available, an attending physician may issue an order not to resuscitate if: he or she has the concurrence of a second physician in writing that the patient is a candidate for
nonresuscitation; and an ethics committee or similar group concurs in the
opinion of the attending and the concurring physician; the patient is receiving inpatient or outpatient treatment from or is a resident of a health care facility other than a hospice or a home health agency.
Revocation or Cancellation: an order not to resuscitate can be revoked by an adult for him or herself, or by any authorized person; a physician or hislher designee may cancel an order not to resuscitate when deemed appropriate.
A DNR order can be carried out when the patient is not in a hospital, nursing
home or licensed hospice as long as the order is evidenced in writing containing the patient's name, date of the form, printed name of the attending physician, and signed by the attending physician on a form similar to the one in the law.

DO NOT RESUSCITATE ORDER

The patient must also be wearing an identifying bracelet on either the wrist or the ankle or an identifying necklace. The bracelet or necklace shall be substantially similar t o the I D bracelets worn in hospitals and must be on an orange background with the following information provided in boldface type:

Patient's name:

DO NOT RESUSCITATE ORDER

Authorized person's name and telephone number, if applicable:

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Patient's physician's printed name and telephone number:

Date of order not t o resuscitate:

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Liability for persons carrying out a DNR order:
No authorized person is subject to any criminal or civil liability for carrying out a DNR order in good faith as long as it was carried out in compliance with the standards and procedures set forth in the law.
For assistance w i t h finding a vendor for bracelets or necklaces, contact the Department of Community Health Office of Regulatory Services at (404) 657-4076.