DNR Declaration in Louisiana: Eligibility, Filing, and Scope

A DNR declaration in Louisiana is a written statement, signed before two witnesses, telling healthcare providers to withhold CPR if you later develop a terminal and irreversible condition. Any adult can sign one, but it only functions as a binding order once two physicians, including your attending physician, personally examine you and certify the diagnosis in writing.¹ The form itself is the easy part. Making sure it reaches the people who need to see it in an emergency is where most of the work lies.

Who Can Have a DNR Honored

Louisiana’s Natural Death Act limits DNR authority to a “qualified patient,” meaning someone certified in writing by two physicians as having a terminal and irreversible condition. One of those physicians must be the attending physician, and both must have personally examined the patient.¹ A terminal and irreversible condition includes a continual profound comatose state with no reasonable chance of recovery, or an injury or disease that will result in death regardless of treatment.

You can sign a declaration long before any of this applies to you. Healthy adults routinely sign in advance so the document is ready if it is ever needed. The declaration simply sits in your record and does nothing until the two-physician certification happens. Only then does it become an enforceable order to withhold CPR.

How to Make the Declaration

Any adult in Louisiana can make a written declaration at any time, directing the withholding or withdrawal of life-sustaining procedures if they develop a terminal and irreversible condition. The declaration must be signed by the person making it in the presence of two witnesses.² A physician does not sign the declaration itself; the physician’s role comes later, in certifying your medical condition.

If you have already been diagnosed with a terminal and irreversible condition and can no longer write, an oral or nonverbal declaration made in front of two witnesses is also valid.² The attending physician must then note in the medical record the reasons the person could not make a written declaration.

Once the declaration exists, the person who made it is responsible for notifying their attending physician. The physician must place the declaration, a copy, or a notation of its existence into the medical record promptly.² A declaration tucked in a filing cabinet at home does nothing during a medical emergency.

Registering the Declaration and Getting the Bracelet

The Louisiana Secretary of State maintains a declaration registry. You can file the original or a certified copy, and in return the Secretary of State issues a standardized Do Not Resuscitate identification bracelet showing your name, date of birth, and the phrase “DO NOT RESUSCITATE.”³

Filing a declaration and receiving the bracelet costs $20. A later revocation costs $5. Checking whether a declaration exists, getting a copy, or receiving information about its contents is free.³

The registry matters most in emergencies. Any attending physician or healthcare facility can contact the Secretary of State to confirm immediately whether a patient has a registered declaration and learn its contents, and a copy transmitted from that office is treated as authentic. A physician is not required to check the registry before withholding treatment if a valid declaration is already in the medical record.³ Both channels exist so emergency responders can find out what you want.

What the DNR Actually Covers

A Louisiana DNR declaration addresses cardiopulmonary resuscitation: the measures used to restore or support heart or breathing function during cardiac or respiratory arrest.¹ When a valid DNR is in place, healthcare providers withhold CPR and related resuscitative efforts.

A DNR does not mean “do not treat.” The statute explicitly excludes comfort care from the definition of life-sustaining procedures. Any measure considered necessary to keep the patient comfortable, including pain medication and other symptom management, must still be provided.¹ Families sometimes worry that signing a DNR means their loved one will be left to suffer. The law does not allow that.

The definition of life-sustaining procedure also includes invasive nutrition and hydration, such as feeding tubes, but only when those measures would serve solely to prolong the dying process for someone with a terminal and irreversible condition.¹ The illustrative declaration form includes a separate initial block for your choice about nutrition and hydration, so you can address that question apart from CPR.

When Someone Else Signs for the Patient

If a person is comatose, incompetent, or otherwise unable to communicate and has not already made a declaration, Louisiana law allows certain people to make one on their behalf. The statute sets a strict priority order, and you move down the list only when no one in a higher category is reasonably available, willing, and competent to act:⁴

A court-appointed guardian or curator, if one has already been appointed. The law does not require you to get an appointment just to make a declaration.
Someone the patient previously named in a signed, witnessed written document to make this decision.
The patient’s spouse, if not judicially separated.
An adult child.
A parent.
A sibling.
Other ascendants or descendants of the patient.

When more than one person falls within the same priority class, say three adult children, the declaration must be made by a majority of that class after a good-faith effort to involve everyone in the group. At least two witnesses must be present when any surrogate makes a declaration.⁴

The absence of a declaration creates no presumption, in either direction, about whether the patient would have wanted life-sustaining treatment.⁴ If no one signs, default medical protocols apply.

Declarations for Minors

A declaration can be made for a terminally ill minor, but the rules are narrower. If the minor has been certified as a qualified patient, only the minor’s spouse (if that spouse is a legal adult) or, if there is no adult spouse, a parent or guardian may make the declaration. A parent or guardian cannot make the declaration if they have actual knowledge that the minor expressed wishes to the contrary, or if another parent, guardian, or adult spouse has raised an objection.⁵ As with adults, making a declaration for a minor is entirely voluntary.

If a DNR Alone Is Not Enough: LaPOST

A DNR declaration answers one question only: whether to perform CPR. If you want direction on ventilators, feeding tubes, or other life-sustaining interventions, Louisiana offers a separate tool called the Louisiana Physician Order for Scope of Treatment, or LaPOST. It is a physician-signed medical order on a standardized, brightly colored form that covers a wider range of treatment decisions.⁶

LaPOST operates under a different set of statutes (La. R.S. 40:1155 through 1155.6) and is not treated as a declaration under the Natural Death Act. It does not need to comply with Natural Death Act requirements to be valid and enforceable.⁷ The specific form must be the version created by the Department of Health; no alterations to the layout or style are permitted without the department’s written permission.⁸

The practical difference matters. With a DNR alone, emergency responders will withhold CPR but may still begin other aggressive interventions like intubation. A LaPOST form lets you specify preferences across a broader range of treatments and is designed to be honored across different care settings, including hospitals, nursing homes, home care, and emergency scenes.⁶ Like a DNR declaration, LaPOST is voluntary; no one can be required to complete one.

Changing Your Mind

A person who has made a DNR declaration can revoke it. The Secretary of State charges a $5 fee to file a notice of revocation.³ If someone other than the patient learns of a revocation while the patient cannot communicate, that person can notify the attending physician of the declaration’s existence or its revocation at any time.

Emergency responders and physicians can only act on what they know. If a declaration has been revoked but the medical record has not been updated and the patient is still wearing a DNR bracelet, providers may withhold CPR in good faith. Removing the bracelet, telling every provider involved in your care, and updating the registry are the practical steps that make a revocation effective.

Declarations from Other States

A declaration properly executed under the laws of another state is treated as valid in Louisiana.⁹ The requirement is that it was properly executed under that state’s law when it was created. The reverse is less certain: a Louisiana declaration carried into another state is honored according to that state’s rules, and formalities differ enough that documents valid here can face questions elsewhere. If you spend significant time in another state, have a local attorney look at your documents.