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How to Create and Record a Do Not Intubate Order in California
Making healthcare decisions in advance can provide peace of mind and clear direction to loved ones and medical teams. In Artesia, California, a Do Not Intubate order communicates that you do not want intubation for breathing support under specified circumstances. Proper legal documentation and communication ensure that medical providers understand and follow your wishes. This guide explains what a DNI order is, how it fits into broader estate planning, and practical steps to document and share your preferences. We focus on clear explanations of the process, legal requirements in California, and ways to make sure your directives are accessible when needed.
Deciding on a DNI order often involves weighing personal values, medical realities, and family considerations. Establishing a clear DNI directive can reduce uncertainty and avoid conflict during urgent medical situations. In California, certain formalities and documentation practices help confirm that a DNI order is legally valid and likely to be followed by healthcare personnel. This section briefly outlines the role of DNI orders within an advance healthcare framework and describes how to integrate that decision with other planning documents such as living wills and powers of attorney for healthcare. Thoughtful preparation helps ensure your care preferences are communicated and respected.
Why a DNI Order Matters for Medical Decision-Making in Artesia
A Do Not Intubate order clarifies whether you want intubation in circumstances where breathing support may be proposed. Having this direction documented helps prevent unwanted medical interventions and guides emergency responders and hospital staff. For families, a valid DNI order reduces the burden of making unpredictable choices during high-stress moments and helps align treatment with the patient’s values and goals for quality of life. Properly prepared documentation also communicates those preferences consistently across care settings. Ensuring your DNI order is accurately recorded and shared with providers and family enhances the likelihood that your instructions will be followed when it matters most.
About Our Estate Planning Practice Serving Artesia
LA Estate Plans focuses on wills, trusts, and probate matters for California residents, including advance healthcare directives such as DNI orders. Our approach emphasizes clear communication, careful document preparation, and attention to California legal requirements so that directives are enforceable and understandable to medical teams. We help clients draft documents that reflect their values, explain signing and witnessing procedures, and assist with distributing copies to doctors and family members. Serving Artesia and surrounding communities, the firm prioritizes respectful guidance and practical solutions that make planning manageable and reliable for individuals and families at any stage of life.
Understanding Do Not Intubate Orders and How They Function
A Do Not Intubate order is a focused medical instruction that indicates a patient’s wish to refuse endotracheal intubation and mechanical ventilation in certain medical scenarios. It is often used as part of broader advance care planning to ensure that respiratory support is not used when it conflicts with the patient’s goals for treatment. In California, a DNI order should be documented clearly and may be included in a living will or other advance directive forms. Proper documentation reduces ambiguity for clinicians and emergency personnel and should be complemented by conversations with family and healthcare providers to confirm that everyone understands the patient’s preferences.
Because medical situations can evolve quickly, a DNI order needs to be precise about the circumstances in which intubation is refused, and reflect the patient’s overall treatment goals. Healthcare providers rely on legally recognized directives to guide urgent decisions, so making sure the order follows California formalities and is accessible to treating clinicians is important. Including a DNI order within a broader advance healthcare plan, and naming a trusted healthcare agent via a durable power of attorney for healthcare, helps to ensure that your wishes are honored across different care settings and that your designated decision-maker can advocate on your behalf.
Defining a Do Not Intubate Order
A Do Not Intubate order explicitly instructs medical personnel not to perform intubation or place a patient on mechanical ventilation under specified conditions. Intubation is an invasive procedure that can be lifesaving in some contexts but may be inconsistent with a patient’s preferences for end-of-life care or quality-of-life considerations. A DNI directive usually addresses only intubation and does not automatically cover other treatments unless those preferences are stated elsewhere in an advance directive. Clear language and proper execution are necessary so that the directive can be located and relied upon by healthcare teams during emergencies.
Key Steps to Create and Implement a DNI Order
Establishing a valid DNI order involves several steps: reflecting on medical goals, discussing wishes with loved ones and clinicians, drafting clear written instructions, and completing any required signatures or witness statements under California law. The directive should be integrated with a living will or similar advance healthcare forms and, where appropriate, accompanied by a durable power of attorney for healthcare to designate a decision-maker. After execution, share copies with primary care physicians, specialists, and designated family members. Periodic review ensures documents remain current, especially after significant health changes or life events that could alter preferences.
Essential Terms Related to DNI Orders and Advance Healthcare Planning
Familiarity with common terms helps make informed choices about DNI orders. Key phrases include advance healthcare directive, living will, durable power of attorney for healthcare, intubation, and code status. Understanding how these elements interact clarifies which documents control decisions in different situations and who will speak for you if you cannot communicate. Knowing the definitions helps you draft directives that are consistent with California requirements and medical practice. Clear terminology in your documents reduces the potential for misinterpretation and supports smooth implementation by clinicians and family members.
Do Not Intubate (DNI)
A Do Not Intubate order instructs clinicians not to insert a breathing tube or use mechanical ventilation for respiratory support in specified circumstances. This directive focuses on intubation and should state the patient’s preferences clearly so emergency and hospital teams can follow those wishes. A DNI may be recorded in medical records, included in a living will, or provided as part of an advance directive package. It is important to make sure the directive complies with California norms and that copies are distributed to treating physicians and family members to minimize confusion in urgent situations.
Advance Healthcare Directive
An advance healthcare directive is a written document that outlines a person’s medical treatment preferences in case they become unable to make decisions. It often includes statements about life-sustaining treatments and may name a healthcare agent authorized to make decisions on the individual’s behalf. In California, having a clear advance directive alongside a DNI order provides a comprehensive view of treatment preferences and the person authorized to interpret those wishes. Regular review of the directive ensures that it reflects current values and medical goals and that responsible parties are aware of its provisions.
Intubation
Intubation is a medical procedure in which a tube is inserted into the airway to assist breathing, commonly used in critical care and emergency settings. While life-saving in many contexts, intubation may extend life in situations where quality of life or long-term recovery prospects do not align with a patient’s wishes. A DNI order communicates a refusal of this procedure under designated conditions. Clear documentation and discussions with medical providers help ensure that the scope of a DNI order is well understood by clinicians and family members during urgent care scenarios.
Living Will
A living will is a legal document that states what types of medical treatment a person wants or does not want if they become incapacitated and cannot communicate. It can include preferences about life-sustaining measures, pain management, and other care choices. Including a DNI order within or alongside a living will ensures that specific instructions about intubation are available to care teams. Keeping copies of the living will accessible to medical providers and appointed decision-makers helps ensure treatment aligns with the person’s stated values and choices throughout the course of care.
Comparing Legal Tools for Medical Treatment Preferences in Artesia
When planning for healthcare choices, individuals may consider several legal documents that serve different purposes. A DNI order targets intubation specifically, while a living will addresses a broader set of life-sustaining treatment preferences. A durable power of attorney for healthcare designates a person to make decisions when you cannot speak for yourself. Understanding the distinctions helps you choose the combination of documents that best reflects your wishes. Coordinating these tools ensures consistent communication across medical settings and provides a backup decision-maker to interpret and implement your directives when required.
When a Focused DNI Order May Be an Appropriate Choice:
Simple Healthcare Preferences
For individuals whose medical preferences are narrow—specifically wanting to refuse intubation while leaving other treatments available—a standalone DNI order can be a clear, efficient way to communicate that choice. This limited approach is useful when the desired direction is straightforward and unlikely to change often. It is important to pair a DNI order with conversations to ensure family members and clinicians understand the scope of the instruction. Keeping the document available in medical records and sharing copies with your doctor helps ensure the directive is recognized and followed in urgent situations.
Short-Term or Specific Medical Situations
A standalone DNI order can be appropriate for temporary health conditions or clearly defined scenarios in which a patient prefers to avoid intubation without making broader decisions about other forms of care. For example, when facing a short-term illness or planned medical treatment where intubation is a potential option, a DNI can prevent a specific intervention while leaving other treatments on the table. Ensuring the directive is documented properly and understood by treating clinicians helps prevent unintended interventions during transient or well-defined medical episodes.
Why Broader Advance Planning Benefits Many Patients:
Complex or Chronic Medical Conditions
Individuals with chronic illness, progressive conditions, or complex medical care needs often benefit from a comprehensive set of documents that address a range of potential treatments and decision-making scenarios. A broad planning approach can include a living will, durable power of attorney for healthcare, and DNI order, ensuring that preferences about intubation and other interventions are all aligned. Comprehensive planning provides clarity for clinicians and surrogates when decisions become complex, helping to ensure that care choices reflect the patient’s values across varying circumstances and stages of illness.
Reducing Burden on Loved Ones
Comprehensive advance healthcare planning reduces the emotional and practical burden on family members called upon to make urgent decisions. Clear written directives combined with the appointment of a trusted decision-maker provide guidance and legal authority to act in accordance with the patient’s wishes. This coordination minimizes uncertainty and conflict among relatives, streamlines communication with medical teams, and supports decisions that respect the person’s values. Regular review and distribution of documents further ensure that loved ones are prepared and informed when they must act on behalf of the patient.
Benefits of Combining DNI Orders with Broader Advance Directives
A comprehensive approach to advance healthcare planning ensures all aspects of medical decision-making are considered and documented. By combining a DNI order with a living will and a durable power of attorney for healthcare, you create a cohesive plan that addresses specific interventions, overall care preferences, and the designation of a decision-maker. This alignment reduces ambiguity for clinicians and supports coordinated care that reflects the patient’s goals. Careful document preparation and communication help ensure preferences are recognized across different care settings and by various providers.
Thorough planning also offers practical benefits such as smoother transitions between levels of care, clearer guidance for emergency responders, and legally sound documents that meet California requirements. Having a complete set of directives reduces the chance of conflicting instructions and makes it easier for healthcare teams to honor the patient’s choices. Sharing copies with key contacts and storing documents where they can be quickly accessed enhances their effectiveness. Regularly revisiting your directives ensures they remain up to date with any changes in health or personal preferences.
Improved Communication with Medical Teams
When directives are clearly written and distributed, medical professionals can more readily understand and follow a patient’s wishes. A documented DNI order placed alongside a living will and powers of attorney creates a consistent message about treatment preferences and who is authorized to make decisions. This clarity helps clinicians make timely choices that align with the patient’s goals, especially in emergencies where rapid action is required. Effective communication decreases the risk of interventions that contradict the patient’s values and supports continuity of care across providers and facilities.
Reduced Decision-Making Burden for Families
Providing clear directives and naming a healthcare decision-maker relieves family members from making difficult calls without guidance. Knowing the patient’s expressed preferences reduces conflict and uncertainty among relatives and creates a legal basis for the designated agent to speak with medical teams. This preparation helps families focus on supporting the patient rather than debating options in crisis situations. By documenting choices in a format that healthcare providers recognize, families can be confident that they are honoring the wishes that the patient set out while able to devote attention to emotional and practical support needs.
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Practical Tips for Managing a DNI Order
Review Documents Regularly
Regular reviews of your DNI order and related advance directives are important to ensure they match your current wishes. Life events, changes in health status, or evolving personal values can affect how you want medical decisions made. Periodic updates help maintain legal validity and reflect any modifications in circumstances. Keeping the directive current also ensures that healthcare providers and family members have the most accurate instructions, which reduces the chance of unwanted treatments and promotes consistent implementation across care settings.
Communicate Your Wishes
Document and Share Properly
After finalizing a DNI order, make sure it is executed according to California formalities and that signed copies are provided to treating physicians, hospitals, and any authorized decision-maker. Consider placing documents in medical records where possible and keeping a version readily available at home. Informing emergency contacts about the existence and location of the directive helps first responders and healthcare staff locate instructions quickly. Proper distribution and storage go a long way toward ensuring the directive is effective when it is needed most.
Reasons to Establish a DNI Order in Artesia
Choosing to create a DNI order may be guided by personal values about quality of life, treatment preferences in serious illness, or a desire to avoid invasive respiratory interventions in specific scenarios. A written DNI directive provides clear instruction to medical personnel and reduces the chance of interventions that run contrary to a patient’s stated goals. It can also ease decision-making for family members and designated agents by providing documented authority and direction. For those with chronic conditions or who are planning end-of-life care, a DNI order is an important element of a comprehensive advance healthcare plan.
Beyond personal preference, practical reasons support establishing a DNI order: timely clarity during emergencies, alignment of care with long-term medical goals, and legal documentation that clinicians can follow. Including a DNI order in your healthcare planning helps ensure decisions made in high-pressure situations reflect your values. The process of drafting and sharing the directive also encourages important conversations with family and care providers, making it simpler for those close to you to understand and honor your choices if they must act on your behalf.
Common Situations Where a DNI Order Is Considered
People commonly consider DNI orders when facing chronic or progressive illnesses, advanced age, or palliative care needs where intubation would not align with desired outcomes. Those planning for possible sudden medical emergencies also use DNI orders to express preferences in scenarios where intubation might be proposed. Additionally, individuals who prefer limited invasive interventions or who want to emphasize comfort-based care often include DNI directives as part of broader medical planning. Assessing medical circumstances and personal goals helps determine whether a DNI order is appropriate.
Serious Chronic Illness
When a person has a long-term or progressive medical condition, they may decide a DNI order aligns with their hopes for quality of life and care priorities. In these situations, having written instructions about intubation ensures that emergency and hospital staff are aware of the patient’s preferences, particularly during acute episodes of illness. Documenting these choices as part of a broader advance directive helps integrate other care preferences and designates who should make decisions if the patient cannot communicate their wishes.
End-of-Life Planning
Individuals planning for end-of-life care often use DNI orders to limit specific life-sustaining treatments that conflict with their goals for comfort and dignity. Including a DNI directive within a comprehensive set of advance planning documents helps ensure that the full scope of care preferences is recorded and understood by both family and clinical teams. Clear documentation reduces the likelihood of unwanted interventions and assists clinicians in providing care that aligns with the patient’s values during the final stages of life.
Sudden Medical Emergencies
A DNI order can be especially valuable in sudden medical emergencies where intubation might be proposed quickly and decisions must be made without delay. Having a written directive on file allows emergency responders and hospital staff to act in accordance with the patient’s wishes even if the individual cannot communicate at the time. Ensuring the directive is accessible to first responders and in medical records helps minimize interventions that the patient did not want and supports timely, values-based decision-making under pressure.
We Are Here to Support Your DNI and Advance Healthcare Planning
Why Choose Our Firm for DNI Orders and Healthcare Directives
Choosing careful legal support for advance healthcare planning helps ensure documents comply with California norms and are drafted in clear, actionable language. We focus on creating directives that are practical for medical teams to apply and straightforward for family members to interpret. Our approach involves explaining the available options, drafting the required paperwork, and advising on distribution and storage so your preferences are easy to locate and follow when needed. This attention to detail helps maximize the effectiveness of your DNI and related directives.
We also help clients understand the interaction between DNI orders and other planning documents, coordinating a living will or durable power of attorney for healthcare when appropriate. This integrated approach reduces the chance of conflicting instructions and supports a consistent decision-making framework. By preparing comprehensive and accessible documentation, we aim to reduce uncertainty and provide clear legal pathways for honoring patient wishes across various care environments. Our goal is to make the planning process manageable and dependable for clients and their families.
In addition to document drafting, we advise on practical matters like how to share directives with physicians, hospitals, and emergency contacts, and how to handle signing and witness requirements in California. Ensuring that directives are readily available to those who need them helps ensure they are effective in real-world medical situations. We guide clients through each step of the process with sensitivity to personal concerns and attention to legal detail, helping create advance plans that provide clarity and support at critical moments.
Contact LA Estate Plans to Discuss Your DNI Order in Artesia
How We Handle DNI Orders and Advance Directives
Our process begins with a careful conversation to understand your healthcare goals and the circumstances in which you prefer to refuse intubation. We then outline appropriate document options, prepare clear written directives, and walk you through the formal execution steps required in California. After documents are signed, we recommend steps for distribution to physicians and family and provide guidance on updating or revoking directives if circumstances change. This structured approach helps ensure your choices are documented and accessible across different care settings.
Step One: Initial Consultation and Planning
During the first meeting, we discuss your overall healthcare goals and preferences regarding life-sustaining treatments, including intubation. The conversation focuses on clarifying values, identifying scenarios where a DNI order should apply, and determining whether additional documents such as a living will or durable power of attorney for healthcare are appropriate. This planning stage establishes the foundation for drafting directives that reflect your wishes and helps identify the people who should receive copies and serve as decision-makers if needed.
Understanding Your Wishes and Priorities
We take time to explore your treatment preferences, any existing medical considerations, and how you envision care in serious illness or emergencies. This conversation helps frame the specific language that will be used in a DNI order and related documents. Clear definitions of the circumstances in which intubation should be refused make the directive more useful to clinicians. We also discuss who you trust to speak for you if you cannot communicate, and whether additional documentation is needed to support that person’s role.
Selecting the Appropriate Documents
Based on your preferences, we recommend the most suitable combination of documents—such as a DNI order, living will, and durable power of attorney for healthcare—and explain how they interact. We discuss California formalities for execution, and suggest practical distribution plans so the directives are accessible to doctors and family. Choosing the right documents and drafting them precisely helps ensure your wishes are honored consistently and reduces the potential for confusion or conflicting instructions during medical care.
Step Two: Document Preparation and Review
Once your preferences are established, we prepare the necessary forms and draft language tailored to your situation. The drafting phase includes careful review to ensure clarity, legal sufficiency, and consistency across all documents. We explain the content and answer any questions you or your family may have, making revisions as needed. This review process helps ensure that the DNI order and related directives accurately express your wishes and meet California requirements for recognition in medical and institutional settings.
Drafting Clear, Practical Language
Clear and specific language improves the likelihood that clinicians and emergency personnel will interpret and follow your directives correctly. We avoid ambiguous phrasing and focus on wording that addresses common clinical scenarios while reflecting your personal values. Careful drafting reduces room for misinterpretation and supports consistent application across different care settings. We also ensure that documents reference any relevant medical terms in plain language so family members can readily understand the intent behind the instructions.
Reviewing with Family and Healthcare Providers
We encourage sharing drafts with your designated decision-maker and, where appropriate, with primary healthcare providers so everyone understands the intended scope of the DNI order. Reviewing the documents together helps identify questions or potential conflicts and offers an opportunity to clarify expectations. This collaborative review can improve acceptance by medical teams and reduce surprises during emergencies. It also gives family members confidence that the documented choices reflect the patient’s true wishes and not informal assumptions.
Step Three: Execution and Communication
After finalizing the documents, we guide you through the signing and witnessing or notarization steps required under California rules. We explain where to keep originals, how to place copies in medical records, and best practices for sharing directives with physicians and emergency contacts. We also advise on how to update or revoke directives if your preferences change. Proper execution and effective communication ensure that your DNI order is more likely to be located and followed when critical medical decisions arise.
Signing, Witnessing, and Notarization Guidance
Certain advance healthcare documents have specific signing or witnessing requirements to be legally effective. We provide clear instructions on who should witness signatures, when notarization is advisable, and how to document the execution process to avoid later disputes. Ensuring compliance with these formalities increases the probability that healthcare institutions will accept and follow your DNI order. We also recommend maintaining a record of executed copies and the names of those who witnessed the signing for future reference.
Sharing Directives with Providers and Loved Ones
Once documents are signed, distributing copies to your primary care physician, relevant specialists, and any hospitals you use helps ensure the directives are present in medical charts. Informing family members and the person you have authorized to make healthcare decisions about the location and content of the directives prevents misunderstandings later. We provide practical suggestions for how to store and share documents so they are accessible to those who need them, including keeping a copy at home and filing a copy in your medical records where feasible.
The Proof is in Our Performance
Frequently Asked Questions About DNI Orders in Artesia
What is a Do Not Intubate (DNI) order?
A Do Not Intubate order is a medical directive that instructs healthcare providers not to perform intubation or place a patient on mechanical ventilation for breathing support in specified circumstances. It is a targeted instruction focused specifically on the use of an endotracheal tube and associated ventilatory support. The directive is commonly used as part of advance healthcare planning to express a patient’s wishes regarding respiratory interventions. A DNI order helps medical teams and emergency responders understand whether intubation should be avoided according to the patient’s preferences. When properly documented and accessible, it reduces confusion during emergencies and supports care that aligns with the individual’s goals for treatment and quality of life.
How do I create a valid DNI order in California?
To create a valid DNI order in California, begin by clarifying your wishes with loved ones and your healthcare provider, then draft the directive in clear language that specifies circumstances where intubation should be refused. Including the DNI order within a broader advance directive or living will can provide context and ensure consistency with other care preferences. Proper execution, including any required witnessing or notarization, helps ensure that healthcare facilities will accept and honor the instruction. After signing, provide copies to your primary care physician, any specialists, and appointed decision-makers. Placing a copy in your medical records and informing family members about the directive’s location increases the likelihood that it will be followed in urgent situations.
Can I change or revoke my DNI order once it is signed?
Yes, you can change or revoke your DNI order at any time while you remain mentally competent. It is important to follow California procedures for revocation, which typically involve creating a written revocation, physically destroying a copy, or clearly communicating the change to your healthcare provider and designated agent. Updating related documents and notifying relevant parties helps prevent old instructions from being followed inadvertently. Regularly reviewing and, if necessary, revising your directives ensures they reflect your current wishes. When changes are made, distribute updated copies to medical providers and family members and replace older versions in medical records to avoid confusion.
Do I need a lawyer to prepare a DNI order?
It is not legally required to have a lawyer prepare a DNI order, but consulting a legal advisor can help ensure the document is drafted clearly and executed in a manner consistent with California requirements. Legal assistance is helpful when you want to integrate a DNI order with a living will or durable power of attorney for healthcare, or when your situation involves complex medical considerations. Guidance can reduce the risk of ambiguity and increase the directive’s effectiveness. If you choose to prepare the document without legal help, make sure language is specific and understandable to medical professionals. Regardless of how it is created, share copies with physicians and trusted decision-makers so your wishes are known and can be followed.
Who should I tell about my DNI order once it is completed?
After completing a DNI order, inform your primary care physician, any specialists involved in your care, and the hospital(s) you might use so the directive can be placed in your medical record. Provide physical or digital copies to family members and the person you have appointed to make healthcare decisions. Clear communication ensures those responsible for your care are aware of the directive and can locate it quickly during emergencies. Keeping a readily accessible copy at home and providing one to your medical team reduces the risk that providers will proceed with intubation when it conflicts with your wishes. Regularly confirm that copies remain in relevant medical files and that designated decision-makers know where to find the documents.
What is the difference between a DNI and a DNR?
A DNI order specifically addresses the refusal of intubation and mechanical ventilation for respiratory support, while a Do Not Resuscitate (DNR) order relates to withholding cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. Both orders relate to life-sustaining treatment decisions but cover different interventions. They can coexist as part of a broader advance healthcare plan to reflect nuanced preferences about emergency care. Clearly stating the scope of each directive and how they relate within your advance directives helps medical teams and family members understand which interventions you want or do not want, reducing the potential for misunderstandings in emergency situations.
Does a DNI order affect other medical treatments?
A DNI order applies specifically to intubation and does not automatically withdraw consent for other treatments such as medications, intravenous fluids, or comfort care measures, unless those preferences are included in a separate living will or advance directive. To ensure broader treatment preferences are honored, include clear statements about other interventions in your living will or related documents. This helps medical teams understand your overall goals for care beyond the decision about intubation. Discuss your full treatment preferences with your healthcare provider and consider naming a durable power of attorney for healthcare to make decisions consistent with your values when you cannot speak for yourself. Combining documents creates a clearer overall plan.
How often should I review my DNI order?
It is advisable to review your DNI order and related advance directives periodically, especially after major life events, changes in health, or shifts in your personal values. Regular reviews help ensure that the documents continue to reflect your current wishes and that execution details remain valid under California rules. Updating documents as circumstances change prevents outdated instructions from guiding care decisions. When you revise directives, provide updated copies to your healthcare providers and designated decision-makers, and replace older versions in medical records. Clear labeling of the most recent documents reduces the risk of confusion during emergencies and increases the likelihood that current preferences will be followed.
Can a DNI order be part of a living will?
Yes, a DNI order can be included as part of a living will or other advance healthcare directive. Including DNI language within a living will allows you to express how intubation fits into your broader medical treatment preferences, and helps clinicians interpret your choices in context. A combined approach can be more effective than standalone directives when a patient has multiple related preferences about life-sustaining treatments. When incorporating DNI instructions into a living will, use clear and specific language and coordinate with any power of attorney for healthcare designation to ensure a cohesive plan. Sharing the integrated directive with medical providers and family members helps ensure consistent understanding and application.
What happens if I don’t have a DNI order in place?
If no DNI order or similar directive is in place, healthcare providers typically proceed with medically indicated treatments, including intubation, unless there are other legally recognized instructions stating otherwise. In emergency situations where a patient cannot communicate preferences, clinicians and emergency responders follow standard medical protocols intended to preserve life. This can result in interventions that may not align with the patient’s values if prior directives are absent. Creating and sharing advance directives, including a DNI order if appropriate, reduces the likelihood of receiving unwanted interventions. Clear documentation and communication with medical teams and family help ensure treatments are more closely matched to the patient’s goals.