Georgia's law on cardiopulmonary resuscitation (CPR)

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 to 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 understand the patient's medical condition and whether or not all the criteria have been satisfied to have his or her preferences regarding cardiopulmonary resuscitation met.
For questions, contact the State Legal Services Developer at the Division of Aging Services, 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 Services 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 1-866-55AGING or write to "Information" Georgia Department of Human Services Division of Aging Services, 2 Peachtree Street, NW, Suite 33.384, Atlanta, Georgia 30303-3142.
Revised April 2012

CARDIOPULMONARY RESUSCITATION O.C.G.A. 31-39-1 et. seq.
Definitions 1. CPR- measures used to restore or support cardiac or respiratory function in the event of cardiac or respiratory arrest.
2. 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.
3. Caregiver: an unlicensed assistant who provides direct health related care to patients or residents, a proxy caregiver performing health maintenance activities providing care under the direction and orders of a licensed health care provider.
4. Nurse: a person who is a licensed practical nurse or a registered professional nurse.
5. Physician assistant: a person licensed as a physician assistant.

Other Names for Cardiopulmonary Resuscitation Orders to stop or withhold the administration of cardiopulmonary
resuscitation (CPR) are recognized by a number of names:
DNR Do Not Resuscitate Order Not to Resuscitate No Code
NOTE 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, nurse, physician assistant, caregiver 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; and 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 his/her designee may cancel an order not to resuscitate when deemed appropriate. A revocation can be accomplished in writing, by oral declaration or by any other act that indicates a specific intent on the part of the adult to revoke consent. The revocation must be communicated to or in the presence of an attending physician, nurse, physician assistant, caregiver, health care professional or emergency medical technician.
Effectuating an order:
A DNR order can be carried out for a patient who is not in a hospital, nursing home or licensed hospice when 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 substantially similar to the one provided in the law.

"DO NOT RESUSCITATE ORDER

NAME OF PATIENT: _______________________________________________

THIS CERTIFIES THAT AN ORDER NOT TO RESUSCITATE HAS BEEN ENTERED ON THE ABOVE-NAMED PATIENT.

SIGNED:

____ ATTENDING PHYSICIAN

PRINTED OR TYPED NAME OF ATTENDING PHYSICIAN: __________________________________________________________________

ATTENDING PHYSICIAN'S TELEPHONE NUMBER: __________________

DATE:

"

Bracelet/Necklace Optional
A person who is not in a hospital, nursing home or licensed hospice and has an order not to resuscitate may wear an identifying bracelet on either the wrist or the ankle or an identifying necklace and shall post or place a prominent notice in the person's home or residence to provide notice of the order not to resuscitate.
If such bracelet or necklace is worn, it shall be substantially similar to identification bracelets worn in hospitals and shall provide the following information in boldface type:
"DO NOT RESUSCITATE ORDER
Patient's name: __________________________________________
Authorized person's name and telephone number, if applicable:
_________________________________________________________
Patient's physician's printed name and telephone number: ________________________________________________________
Date of order not to resuscitate: _________________________"
Liability for persons carrying out a DNR order:
No authorized person, health care facility or other licensed facility or their employee acting as an agent for them 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; nor, shall they be subject to civil or criminal liability for providing cardiopulmonary resuscitation to a patient for whom an order not to resuscitate has been issued provided that such physician or person reasonably and in good faith was unaware of the order or believed consent was revoked.