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Understanding DNI Orders Within Estate Planning
Planning for medical decisions is an essential part of estate planning in El Segundo, California. A Do Not Intubate (DNI) order tells healthcare providers not to perform intubation when breathing support would otherwise be used. This guide explains how DNI orders fit into broader advance care planning, when they may be appropriate, and how they interact with other documents such as advance healthcare directives and proxies. By learning how DNI orders work in California and how to document them properly, residents can ensure medical care aligns with their values and that family members and providers have clear directions during emergencies.
Deciding whether a DNI order is right for you involves considering your medical priorities, values about quality of life, and how you want breathing support handled if you are unable to communicate. Integrating a DNI order with estate planning helps ensure that medical and legal wishes are coordinated and accessible to the right people. This section describes the practical steps to create, communicate, and update a DNI order in El Segundo while highlighting the importance of clear documentation and regular review so that your current preferences are honored when it matters most.
Why a DNI Order Matters for Your Medical and Estate Planning
A DNI order gives a clear, legally recognized instruction about intubation that helps prevent unwanted invasive interventions during serious illness or medical crises. Including a DNI order within a complete estate plan reduces ambiguity for healthcare providers and family members, limiting disagreements at stressful times. It supports patient-centered decision making by documenting preferences about breathing support and by indicating how those choices should be applied in emergency situations. For El Segundo residents, a well-crafted DNI order provides peace of mind, protects personal dignity, and contributes to a coordinated approach to medical and legal decisions when capacity is limited.
About LA Estate Plans and Our Approach to DNI Orders in El Segundo
LA Estate Plans focuses on helping individuals throughout El Segundo and Los Angeles County plan for medical decisions and estate matters. Our practice supports clients with clear guidance on how DNI orders function under California law, integrating these directives with advance healthcare documents, wills, and trusts. We emphasize personalized consultations to understand each client’s values, recommend appropriate document language, and explain steps for execution and distribution. Our goal is to make the process understandable and manageable so clients in El Segundo can make informed choices and ensure their medical preferences are documented and accessible when needed.
Understanding DNI Orders and How They Work in California
A Do Not Intubate order specifically addresses whether medical staff should place a breathing tube to assist with respiration during respiratory failure or distress. In California, DNI orders are either standalone medical orders or part of a broader advance healthcare directive or Physician Orders for Life-Sustaining Treatment. To be effective, a DNI order must be documented clearly, signed by the patient or authorized decision-maker, and communicated to treating clinicians. Residents of El Segundo should understand how a DNI interacts with other directives and who will be responsible for carrying out those wishes in clinical settings to ensure consistency across care teams.
When preparing a DNI order, it is important to consider scenarios in which intubation might be proposed and whether other treatments would remain acceptable. A DNI order does not necessarily prohibit other forms of care such as oxygen, medications, or comfort measures unless specifically stated. Regular review and updates are recommended, particularly after changes in health, new diagnoses, or shifting priorities. Clear communication with designated healthcare decision-makers, primary care physicians, and family members helps ensure that the DNI order will be followed in emergencies faced by El Segundo residents.
What a Do Not Intubate Order Means
A Do Not Intubate order is a written instruction stating that a patient does not want intubation performed to manage breathing. Intubation is a procedure where a tube is inserted into the airway to support breathing and is commonly used in emergency or critical care. The DNI order focuses specifically on that procedure and is distinct from instructions about resuscitation or other life-sustaining measures. In California, properly executed DNI orders are part of the medical record and must be accessible to healthcare teams to ensure that the patient’s specific preferences are honored during emergency interventions or when the patient cannot communicate.
Key Elements Required for a Valid DNI Order
To create an effective DNI order you should document clear language refusing intubation, include the patient’s signature or that of an authorized decision-maker, and obtain any required acknowledgment from a healthcare professional when applicable. The order should indicate whether it stands alone or forms part of an advance healthcare directive. Once signed, it is important to distribute copies to treating physicians, family members, and medical facilities and to include it in electronic health records if possible. Periodic review, especially after significant changes in health or personal circumstances, helps keep the directive current and reliable in practice.
Important Terms and Definitions Related to DNI Orders
Understanding the language used in medical directives makes it easier to create documents that accurately reflect your wishes. Key terms include DNI, advance healthcare directive, intubation, and healthcare proxy. Each term has a specific legal and clinical meaning that affects how directives are interpreted and applied during medical care. This glossary clarifies those meanings and explains their practical implications so residents of El Segundo can make well-informed decisions and communicate clearly with healthcare providers and appointed decision-makers about preferences for breathing support and related treatments.
Do Not Intubate (DNI) Order — Meaning
A Do Not Intubate order is a formal instruction that tells medical personnel not to perform intubation to assist breathing. It is intended for situations where a patient prefers to avoid invasive airway procedures. The DNI order may be included within a larger advance healthcare directive or exist as a standalone medical order. Its primary purpose is to ensure that, in cases of respiratory failure or distress, the patient’s explicit decision about intubation is available to clinicians so that care aligns with the patient’s stated preferences and goals for treatment.
Advance Healthcare Directive — Overview
An advance healthcare directive is a legal document that communicates a person’s medical care preferences and appoints a healthcare agent to make decisions if the person cannot do so. It can include instructions about life-sustaining treatments, palliative care, and specific interventions like intubation or resuscitation. Including a DNI order within an advance healthcare directive helps ensure that those wishes are documented alongside other medical preferences and that an appointed agent understands and can advocate for the individual’s choices in clinical situations.
Intubation — What It Involves
Intubation is a clinical procedure where a tube is inserted into the airway to support or secure breathing, often used during surgeries, in intensive care units, or in emergencies. The procedure can be life-saving but may also be invasive and carry risks and implications for a patient’s recovery or comfort. A DNI order specifically addresses whether this procedure should be performed, enabling individuals to avoid intubation while allowing other treatments unless those are explicitly refused as well.
Healthcare Proxy or Agent — Role Explained
A healthcare proxy, also called a healthcare agent, is a person designated to make medical decisions for someone who is incapacitated. The agent is expected to follow any written directives, such as a DNI order, and to make choices consistent with the patient’s known wishes and values. Selecting and communicating with a trusted proxy ensures that there is someone authorized and prepared to carry out healthcare instructions and to work with providers to implement the patient’s medical preferences in El Segundo medical settings.
Comparing DNI Orders, DNRs, and Advance Healthcare Directives
When planning medical directives, it helps to compare options like DNI orders, Do Not Resuscitate (DNR) orders, and advance healthcare directives. Each serves a different purpose: a DNI focuses on intubation, a DNR addresses resuscitation efforts, and an advance healthcare directive covers broader preferences and appoints an agent. Choosing the right combination depends on individual priorities regarding specific interventions and overall care goals. In El Segundo, discussing these choices with family and healthcare providers aids in building a clear, coordinated plan so medical teams understand how to act according to your preferences.
When a Targeted DNI Order May Meet Your Needs:
Preference to Decline Intubation Only
Some individuals want to refuse intubation specifically while still accepting other forms of medical care. A narrowly tailored DNI order addresses that precise preference without affecting decisions about other treatments such as antibiotics, pain management, or noninvasive oxygen support. This approach can be suitable when the goal is to avoid an invasive airway procedure while preserving access to comfort-focused or supportive measures. For people in El Segundo who value a focused directive, a standalone DNI can provide clarity to both clinicians and loved ones about that single, specific choice.
Simpler Documentation for Specific Wishes
A DNI order can simplify decision-making by addressing one explicit procedure rather than a broad range of interventions. This straightforward directive can reduce confusion in emergency moments because it communicates a single, clear instruction about intubation. For individuals who want uncomplicated paperwork and direct communication of a specific preference, especially those with stable health or particular medical goals, a standalone DNI order offers an effective way to make that priority clear to medical teams and family members in El Segundo without creating an extensive advance care plan.
Why a Comprehensive Estate Planning Approach Is Often Recommended:
Coordination of Medical and Financial Directives
A comprehensive estate planning approach coordinates medical directives like DNI orders with wills, trusts, and financial plans so that all aspects of your affairs are aligned. This integration helps ensure that the person making medical decisions also has clear legal authority and that financial and personal matters are handled according to your intentions. For residents of El Segundo, combining medical orders with estate planning documents reduces the risk of inconsistencies or gaps that could cause delays, disputes, or uncertainty when decisions must be made under stress.
Reducing Family Burden and Legal Uncertainty
A full planning approach decreases the emotional and administrative burden on family members by providing clear guidance for both medical and legal decisions. Detailed directives and properly executed documents minimize disagreement among relatives and deliverables to providers. Ensuring that DNI orders, proxies, and estate documents are consistent and accessible helps families in El Segundo avoid unnecessary conflict and ensures smoother decision-making during difficult times, giving loved ones a practical framework to follow when carrying out your wishes.
Benefits of Integrating DNI Orders into Full Estate Plans
Bringing DNI orders together with wills, trusts, and other advance directives creates a unified plan that covers medical, financial, and personal affairs. This holistic view helps ensure that medical preferences are documented in alignment with broader estate objectives, reducing the chance that one element will conflict with another. In El Segundo, having a coordinated plan means healthcare providers and family members are more likely to find consistent instructions, and legal authority for decision-making is more clearly established, which helps carry out your wishes effectively when circumstances change.
A comprehensive plan also supports better continuity of care and reduces the administrative hurdles that can arise during medical emergencies. When DNI orders are part of an overall estate strategy, it becomes easier to maintain updated records, distribute copies to appropriate providers, and integrate documents into medical charts. This organization helps ensure rapid access to your directives in urgent situations and reduces delay or confusion about your preferences, offering residents of El Segundo a practical way to protect their medical choices and personal affairs.
Clear Authority and Reduced Conflict
One major benefit of comprehensive planning is identifying who is authorized to make medical decisions and ensuring that authorization aligns with written directives. Clear delegation reduces the likelihood of disputes among family members and provides medical teams with a recognized decision-maker who can implement DNI orders and other wishes. For El Segundo residents, this clarity eases emotional strain on loved ones and creates a more straightforward path for carrying out medical and legal preferences during stressful events, supporting smoother, more respectful decision-making.
Better Document Management and Accessibility
When DNI orders are integrated into an estate plan, documents are organized and distributed so that they are more likely to be located when needed. This includes advising clients on where to store documents, who should receive copies, and how to include directives in medical records. For people in El Segundo this means faster recognition of wishes in emergency settings and a lower risk that important instructions will be overlooked. Consistent document management reduces friction in critical moments and improves the likelihood that medical care aligns with stated preferences.
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Practical Tips for Preparing a DNI Order
Communicate Your Wishes Clearly
Discuss your DNI order and overall healthcare preferences openly with family members and the person you designate to make medical decisions so they understand your values and intentions. Clear conversations reduce misunderstandings during emergencies and prepare your healthcare proxy to advocate for your choices. Bringing healthcare providers into the discussion can also clarify clinical implications and ensure the language you use in documents is easily understood by medical teams in El Segundo and beyond.
Keep Your Documents Accessible
Review and Update Regularly
Periodically review your DNI order and accompanying estate planning documents to ensure they still reflect your current wishes and health status. Changes in medical condition, treatment options, or personal preferences may warrant revisions. Make updates when life events occur, and notify your healthcare team and designated agent to maintain consistency across documents and to avoid confusion when directives must be followed.
Reasons to Consider a DNI Order as Part of Your Plan
A DNI order can be appropriate for individuals who want to avoid invasive airway interventions while preserving other forms of care. It provides a specific, enforceable instruction about intubation that reduces the chance of receiving unwanted procedures. For people with chronic conditions, advanced age, or preferences for comfort-focused care, a DNI order helps align medical treatment with personal values. Including a DNI within broader planning ensures that medical choices are consistent with financial and legal plans and makes expectations clear to loved ones and clinicians.
Beyond personal health preferences, families often benefit from the clarity a DNI order provides. It reduces uncertainty in moments that are emotionally charged and helps avoid disputes about appropriate interventions at critical times. In El Segundo, having a properly executed DNI order means medical staff and family can act quickly and with confidence that the patient’s wishes regarding intubation will be followed. This practical guidance can ease the decision-making burden during emergencies and support more peaceful outcomes for everyone involved.
Common Situations Where a DNI Order Is Considered
DNI orders are frequently considered by those with progressive illnesses, respiratory conditions, advanced age, or by individuals who prioritize comfort care over invasive interventions. They are also useful for anyone who wants to plan ahead and ensure that their preferences about intubation are known and followed. Emergency scenarios in which a patient cannot communicate make DNI orders especially important as they provide immediate direction to medical teams and reduce the need for family members to make difficult choices without guidance.
Advanced or Terminal Illness
Individuals facing progressive or terminal illnesses often include DNI orders as part of their care planning to avoid invasive airway management that may not improve quality of life. Clearly documenting a preference against intubation helps align treatment with goals that emphasize comfort and dignity and spares families from making urgent decisions without guidance. In El Segundo, residents in these circumstances frequently find a DNI order can provide important clarity for both clinicians and loved ones.
Reduced Tolerance for Invasive Treatments
Some people prefer to avoid highly invasive procedures that can prolong life but reduce comfort or independence. A DNI order allows them to decline intubation while still accepting other forms of medical care. Documenting this preference helps healthcare teams respect those limits and directs family members about how to act if situations arise where breathing support is considered.
Proactive Planning for Emergencies
Even individuals without serious chronic conditions may choose DNI orders as part of proactive emergency planning. Having clear instructions in place prevents uncertainty in crises where the patient cannot speak, ensures that wishes are available to emergency responders and hospital staff, and provides guidance to designated decision-makers. For El Segundo families, this preparation can lessen stress and improve the likelihood that care will reflect the patient’s preferences.
We Are Here to Help With DNI Orders in El Segundo
Why Choose LA Estate Plans for DNI Orders and Estate Planning
Clients in El Segundo rely on LA Estate Plans for focused assistance in crafting medical directives and coordinating them with broader estate documents. We emphasize clear communication, practical drafting, and step-by-step guidance to ensure documents comply with California requirements and reflect personal values. Our approach helps individuals and families achieve clarity about medical preferences and decision-making authority so that choices can be followed in clinical settings without undue delay or dispute.
We work with clients to prepare DNI orders that specify the desired scope of medical care and to integrate those orders into advance healthcare directives, wills, or trusts when appropriate. This coordination enhances the accessibility and legal standing of your directives and helps ensure that your wishes are consistently interpreted by medical providers and family members. For El Segundo residents, having well-prepared documents reduces the administrative burden during crises and improves the chance that care will align with stated goals.
Our team also advises clients on practical steps such as distributing copies to providers, storing originals safely, and scheduling periodic reviews to reflect changes in health or preferences. Clear documentation and communication reduce the likelihood of confusion or conflict, giving families practical instructions to follow during stressful times. If you want assistance preparing or updating a DNI order in El Segundo, we provide guidance tailored to your situation and help ensure the process is straightforward and reliable.
Call LA Estate Plans to Discuss Your DNI Order — 310-634-1006
Our Process for Creating and Implementing DNI Orders
Our process begins with a detailed conversation about your medical goals and personal priorities, followed by careful drafting of DNI language that reflects your wishes within California law. We review existing documents, advise on distribution to medical providers and family members, and assist with signing formalities. After the DNI order is finalized, we provide instructions for including it in medical records and recommend a schedule for periodic review. This structured approach helps ensure your preferences can be quickly identified and respected when needed.
Step One: Initial Consultation and Needs Assessment
The initial meeting focuses on understanding your values, health status, and goals for medical care. We discuss scenarios where intubation might be considered and how a DNI order would apply. During this assessment we clarify whether a standalone DNI or integration into an advance healthcare directive better suits your needs and identify who you would like to designate as your healthcare agent. This conversation forms the basis for drafting clear, practical instructions that reflect your wishes.
Review of Current Documents and Medical History
We examine any existing advance directives, medical orders, or estate planning documents to ensure consistency and identify gaps. Reviewing medical history and current treatment preferences helps craft DNI language that aligns with your overall care plan. This review prevents conflicting instructions and allows us to advise on how best to coordinate medical directives with other estate planning documents to support your intentions in El Segundo.
Discussing Goals and Designating a Healthcare Agent
We help you think through who should act as your healthcare agent and how to communicate your wishes to that person. Selecting a trusted agent and discussing specific scenarios prepares them to make decisions consistent with your directives. Clear direction for the agent, including preferences about intubation and other life-sustaining treatments, reduces uncertainty and supports timely, aligned decisions in clinical situations.
Step Two: Drafting and Finalizing Your DNI Order
During drafting we produce clear, unambiguous language that reflects your choices and meets California legal standards. The draft is reviewed with you to confirm it expresses your intentions accurately and to answer any questions about implications or wording. We then guide you through the execution process, including any necessary witness signatures or acknowledgments, and prepare copies for distribution to relevant parties so the order is accessible when needed.
Preparing Clear Document Language
Drafting focuses on specificity and plain language so medical personnel can readily interpret and apply the directive. We avoid vague phrases and include precise instructions about intubation and any related treatments you want to accept or decline. Clear phrasing helps prevent misinterpretation and ensures that your DNI order functions effectively within clinical workflows in El Segundo hospitals and clinics.
Execution and Document Distribution
After finalizing the document, we assist with signing requirements and recommend who should receive copies. Providing copies to primary care physicians, local hospitals, and your designated agent enhances the likelihood the DNI order will be located and followed in emergencies. We also advise on storing the original document and on how to notify relevant parties when changes are made.
Step Three: Implementation, Follow-Up, and Periodic Review
Once the DNI order is in place, we provide guidance on integrating it into medical records, communicating with healthcare teams, and ensuring your agent and family understand its contents. We recommend periodic reviews to reflect changes in health or personal preferences and offer ongoing assistance for updates or revocations as circumstances evolve. This follow-up helps keep your directives current and actionable when timely decisions are required.
Bringing the Order into Medical Records
We help facilitate adding the directive to electronic health records or ensuring that hospitals and clinicians have copies. Including the DNI order in medical charts increases the chance it will be seen and followed by clinical teams at the moment it is needed. Clear placement in records reduces delays and helps align emergency responses with your stated preferences.
Periodic Review and Assistance with Changes
We recommend reviewing your DNI order after major health events or life changes and can assist with revisions or revocations when you choose to alter your instructions. Regular check-ins help confirm that the document still reflects your goals and that all relevant parties are aware of updates. Ongoing support ensures your directives remain effective and aligned with current needs and wishes.
The Proof is in Our Performance
Frequently Asked Questions About DNI Orders in El Segundo
What is a DNI order and how does it differ from other medical directives?
A Do Not Intubate order is a written instruction directing medical staff not to perform intubation to assist breathing. It specifically addresses the placement of a breathing tube and is intended for situations of respiratory failure or severe distress when the patient cannot communicate. A DNI order differs from a Do Not Resuscitate order because a DNR addresses cardiopulmonary resuscitation in the event of cardiac arrest, while a DNI focuses only on intubation; both can be part of a comprehensive advance care plan. Including a DNI order within an advance healthcare directive or as a standalone medical order ensures that clinicians and family members understand the patient’s wishes regarding intubation. To be effective, the order should be clearly written, properly signed, and made available to treating providers. Discussing the directive with medical professionals and designated decision-makers helps clarify how it will be applied in different clinical scenarios and supports better alignment between stated preferences and delivered care.
How do I create a valid DNI order under California law?
To create a valid DNI order in California, you should clearly state your decision about intubation in writing and sign the document yourself or have an authorized decision-maker sign if you lack capacity. In many cases a DNI can be part of an advance healthcare directive or a separate medical order; certain forms may require acknowledgment by a healthcare provider. Ensuring compliance with state requirements and using unambiguous language helps make the directive effective in clinical settings. After drafting the DNI order, distribute copies to your primary care physician, any specialists, local hospitals you use, and your designated healthcare agent. Place a copy in your medical records when possible and inform family members where to find the document. Regular review and confirmation of signatures and distribution help maintain the order’s validity and accessibility when it is needed.
Can I change or revoke my DNI order after it is signed?
Yes, you can change or revoke a DNI order at any time while you have decision-making capacity. Revocation typically requires a clear statement of intent to withdraw the order, and you should communicate that change directly to your healthcare providers, the facilities where your medical records are kept, and to any appointed healthcare agent. Prompt notification helps ensure that your updated wishes are recognized and followed in future care decisions. It is important to execute any changes in writing when possible, and to provide revised copies to all relevant parties. If an authorized decision-maker previously signed on your behalf, documentation confirming the revocation and the patient’s current capacity may be required. Regularly updating documents and confirming distribution reduces the risk of outdated instructions being applied in emergency situations.
Will a DNI order prevent all medical treatment?
A DNI order specifically declines intubation but does not automatically prohibit other forms of medical treatment unless those are explicitly refused. Patients can accept treatments such as medications, oxygen therapy, noninvasive ventilation, or comfort care while declining intubation. The scope of withheld or allowed interventions should be made explicit in accompanying documentation to avoid misinterpretation by medical staff. When preparing a DNI order, discussing other care preferences and including them in an advance healthcare directive helps provide comprehensive guidance. Clear statements about what treatments remain acceptable will give clinicians and family members practical instruction, reduce confusion, and better align medical care with the patient’s overall goals for treatment and comfort.
How do DNI orders interact with a healthcare agent or proxy?
A healthcare agent or proxy makes medical decisions when a patient lacks capacity, and that person is generally expected to follow any written directives such as a DNI order. The agent’s role is to advocate for the patient’s stated wishes and to interpret care decisions in light of those directives. Clear communication between the patient and their chosen agent prior to incapacity helps ensure the agent understands the patient’s values and the intent behind the DNI order. If a written DNI order exists, it usually takes precedence over substitute decision-making when applicable, but agents should still be familiar with the document and ready to present it to clinicians. When conflicts arise, having a properly executed, well-distributed DNI order and documented conversations with the agent reduces ambiguity and supports the implementation of the patient’s preferences.
Do hospitals and emergency personnel in El Segundo follow DNI orders?
Properly executed DNI orders are legally recognized and should be followed by hospitals and emergency personnel in California provided the document is accessible and meets statutory requirements. Emergency responders and hospital clinicians will look for medical orders and advance directives in the patient’s records, with designated agents or family members often providing copies in urgent situations. Making sure the DNI order is included in medical charts and that providers have copies increases the likelihood it will be honored in clinical care. To improve implementation, inform your primary care provider, local hospitals, and emergency contacts about the existence and location of the DNI order. Including the document in electronic health records where possible and giving copies to the people most likely to be present during emergencies supports prompt recognition and adherence to your wishes by treating teams in El Segundo and surrounding areas.
Should I include a DNI order in an advance healthcare directive or keep it separate?
You may include a DNI order within a broader advance healthcare directive or keep it as a standalone medical order depending on personal preference and clinical needs. Including DNI language in an advance healthcare directive can centralize all medical preferences and agent designations into one document, simplifying record keeping. Conversely, a separate DNI order can provide a direct, easily identifiable instruction about intubation without addressing additional care preferences. Choosing the best option often depends on whether you want a single, comprehensive document or a focused directive addressing only intubation. Discussing options with healthcare providers and legal advisors can help determine which format best ensures clarity, accessibility, and compliance with California practices for El Segundo residents.
How often should I review my DNI order and related documents?
It is recommended to review your DNI order and related estate planning documents periodically and after significant life events such as major health changes, new diagnoses, or changes in family structure. Regular reviews confirm that the language still reflects current preferences and that contact and distribution information remains accurate. Scheduling routine check-ins helps keep documents up to date and ensures that everyone involved understands the current instructions. When you review the DNI order, provide updated copies to healthcare providers, the named agent, and any institutions that maintain your medical records. Confirming that the directive is recorded in electronic health systems where possible and informing emergency contacts of revisions helps maintain the order’s effectiveness when prompt decisions are needed.
What steps should I take to make sure my DNI order is accessible in an emergency?
To make a DNI order accessible in an emergency, place copies with your primary care physician and any specialists, deliver copies to local hospitals you are likely to use, and provide a copy to your designated healthcare agent and close family members. If your healthcare provider can add the directive to your electronic health record, that will increase the chance it is available quickly to treating clinicians. Carrying a card in your wallet indicating that you have a DNI order and where it is located can also help first responders locate the document rapidly. Ensure that those who might present the document in an emergency know the document’s significance and location. Regularly verify that copies are current and that the medical facilities you use have acknowledged receipt. Clear distribution and ongoing communication reduce delays and increase the likelihood that your DNI preferences are followed.
Can I have a DNI order even if I am not terminally ill?
Yes, a DNI order is not limited to people who are terminally ill and can be used by anyone who wishes to decline intubation under certain circumstances. Individuals who prioritize comfort care, those with chronic respiratory conditions, or anyone who prefers to avoid invasive airway procedures may choose to document a DNI order proactively. Having the directive in place prevents uncertainty if an unexpected medical crisis occurs and you cannot communicate your wishes. Choosing a DNI order as part of proactive planning helps ensure that your preferences are known and available to medical teams and family members. If you are unsure about whether a DNI or another form of directive is appropriate, discussing your goals with clinicians and legal advisors can help you select the approach that best aligns with your values and circumstances in El Segundo.