Living Will vs. DNR: Key Differences

When planning for the future, it’s common to focus on your estate and financial assets. Healthcare decisions are another part of that planning. Advance medical directives can record your preferences for future care and identify who has authority to make healthcare decisions if you cannot communicate. A living will and a do-not-resuscitate (DNR) order are two options, but each addresses different medical decisions.

A financial advisor can help you sort through the pros and cons of both options and financially prepare your assets for the event where you actually need to use them.

A Living Will Explained

A living will records the medical care you would want if you are no longer able to make or communicate your choices. Depending on the document and applicable state law, those instructions may apply if a serious illness, injury or other condition leaves you incapacitated.

You can use a living will to state your preferences concerning treatments that could prolong your life. Those instructions might address mechanical ventilation, dialysis, artificial nutrition and hydration or other forms of medical intervention.

Requirements for living wills vary by state. Rules can differ on issues such as signatures, witnesses and notarization. You can also revise or revoke your instructions while you retain the legal capacity to do so.

A living will is often paired with a power of attorney for healthcare. Rather than listing treatment preferences, this document gives another person authority to make healthcare decisions for you under specified circumstances. Having both documents can provide written guidance while also giving someone authority to address medical situations that were not specifically covered.

Do-Not-Resuscitate Order Explained

A DNR addresses whether resuscitation should be attempted during a medical emergency. It directs the healthcare team to withhold cardiopulmonary resuscitation when a patient experiences cardiac or respiratory arrest.

Its scope is much narrower than that of a living will. A DNR concerns resuscitation and does not, by itself, reject every other form of medical care. Other treatment can continue according to the patient’s condition, preferences and care plan.

People may consider a DNR when CPR would be inconsistent with their treatment goals or medical circumstances. The decision is not restricted to a particular age group or diagnosis.

How a DNR is created and recognized depends on state law and the setting in which care is provided. Requirements for an order used in a hospital can differ from those for instructions intended to apply at home or when emergency medical services respond.

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Key Differences Between Living Wills and DNRs

A living will generally addresses a broader range of future treatment choices. It can explain what types of care you would accept or decline if you become unable to express those decisions yourself.

A DNR deals with a specific emergency situation. Rather than setting out a wider plan for medical treatment, it establishes whether CPR should be used following cardiac or respiratory arrest.

The documents can therefore serve complementary purposes. Someone could use a living will to record preferences about life-prolonging treatment while separately establishing a DNR when the decision about resuscitation needs to be documented as a medical order.

Neither document necessarily appoints another person to make healthcare decisions. That authority can instead be provided through a healthcare power of attorney or another document recognized under state law.

How POLST and MOLST Forms Work

Some people with serious illnesses or advanced medical needs may also use a portable medical order. Depending on the state, it may be called a POLST or Medical Orders for Life-Sustaining Treatment (MOLST) form. These forms turn a patient’s current treatment choices into medical orders rather than simply recording preferences for possible future circumstances.

Depending on the form used in a particular state, the orders can address decisions about resuscitation as well as other forms of medical treatment. They are generally intended for patients whose health makes those treatment decisions immediately relevant rather than for every adult completing an estate plan.

A POLST or MOLST can be used alongside a living will and healthcare power of attorney. The advance planning documents provide broader instructions or decision-making authority, while the medical orders address treatment choices that apply to the patient’s current condition.

Do You Need a Living Will or a DNR?

The appropriate document depends on the decisions you want recorded. A DNR may address your needs if your concern is specifically whether CPR should be attempted during cardiac or respiratory arrest.

A living will provides room to address additional medical circumstances. For example, you may want to state your preferences concerning ventilation, artificial nutrition or other life-prolonging treatments if you become unable to communicate.

You can also have both. The living will can establish broader treatment preferences while the DNR addresses resuscitation. A healthcare power of attorney can separately give another person authority to make medical decisions when necessary.

Because state requirements differ, the documents should be prepared according to the rules where they will be used. Your doctor can discuss the medical implications of your choices, while an attorney can explain the requirements for advance directives in your state.

Bottom Line

Living wills and DNR orders address different parts of advance healthcare planning. A living will can establish instructions covering several types of future medical care, while a DNR records the decision not to use CPR following cardiac or respiratory arrest. Other documents, including a healthcare power of attorney and MOLST, may address additional treatment decisions or designate someone to act for you. Discussing these documents with your healthcare provider and an estate planning attorney can help determine which ones fit your circumstances.

Tips for Estate Planning

Consider working with a financial advisor as you do your estate planning to best protect your interests. They can help you set up your entire estate plan and help you financially prepare your assets for when you die. Finding a financial advisor doesn’t have to be hard. SmartAsset’s free tool matches you with vetted financial advisors who serve your area, and you can interview your advisor matches at no cost to decide which one is right for you. If you’re ready to find an advisor who can help you achieve your financial goals, get started now.
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