A story with a moral that applies:
I volunteer with my town's ambulance service. Last night I was toned out for a "man not breathing." When we arrived, we determined that the patient was a 90-year old man in cardiac arrest and that he had been down for probably 6-8 minutes.
We began our invasive and, quite frankly, violent CPR and ACLS protocols, only to have the patient's daughter tell us "No, he doesn't want all that." We asked her if he had an advanced directive or DNR, and she said yes. We asked to see the DNR, and it could not be found, despite assurances from the daughter and the home health aid that he had one.
Our protocols and state law are clear: in the absence of a valid written DNR in hand, you go to work, which is what we did.
Moral of the story: Even if you do all of the advanced planning in the world, if the documents are not readily available, they are useless. NY State recommends taping them to the refrigerator door in the kitchen.
The patient was pronounced dead shortly after we arrived at the hospital, despite our best efforts to revive him. If he really did have a DNR, I feel bad about what we put him through, but in a litigious society these rules are absolute. I'd also much rather take the risk of resuscitating someone who doesn't want it, than not working someone who wanted it. Please don't judge me on the decision.