Do Not Resuscitate Orders in Pennsylvania

A Do Not Resuscitate (DNR) order is a physician-signed medical order that tells first responders and hospital staff not to perform CPR if your heart stops or you stop breathing. In Pennsylvania, DNR rules are tightly defined by statute and are different from a living will.

The Out-of-Hospital DNR

Pennsylvania has a specific statute — the Do-Not-Resuscitate Act, 20 Pa.C.S. Chapter 54A — for out-of-hospital DNRs. To be valid, the order must be:

• Signed by the patient's attending physician
• On the Department of Health's official form, bracelet, or necklace
• Issued only to patients with an end-stage medical condition or who are permanently unconscious

Without the official form or device, EMS in Pennsylvania will perform CPR even over family objections.

In-hospital DNRs

Inside a hospital, DNR orders are entered into the medical record under the hospital's own policy. A living will or healthcare POA decision can trigger an in-hospital DNR; the out-of-hospital form is what governs paramedics in the home.

DNR vs. living will

• A living will is a written statement of your wishes, used by physicians to guide decisions
• A DNR is a physician's actual medical order, immediately actionable by clinicians and EMS

A living will alone will not stop paramedics in a Pennsylvania home from performing CPR. If avoiding resuscitation outside the hospital is important to you, you need both the living will and the out-of-hospital DNR.

POLST as a successor

The Pennsylvania POLST form (Orders for Life-Sustaining Treatment) is a more comprehensive physician order set that covers DNR plus other end-of-life decisions (intubation, artificial nutrition). For patients with serious illness, POLST has largely replaced the standalone DNR.

When to talk to a lawyer

Estate planning attorneys do not issue DNRs — only physicians can. But we do draft the living will and healthcare POA that make your wishes legally enforceable, and we help families coordinate those documents with the medical orders. See our advance directive guide.