A Do Not Resuscitate order in Michigan is a written instruction, signed by you and your attending physician, that tells emergency personnel outside a hospital not to perform CPR if your heart stops or you stop breathing. The order is governed by the Michigan Do-Not-Resuscitate Procedure Act (Public Act 193 of 1996), and it only works if it is executed exactly the way the statute requires and backed up by the identification bracelet first responders look for in the field.
What Makes a Michigan DNR Order Valid
The execution rules sit in MCL 333.1053 and MCL 333.1054. The order has to be in writing, on a form that matches the statutory language, and it must carry three signatures:
- The declarant (the person the order is for).
- The declarant’s attending physician.
- One witness. The statutory form in MCL 333.1054 provides a single witness signature line.
The form must include a statement confirming it complies with the Michigan Do-Not-Resuscitate Procedure Act. The declarant also has to be mentally capable of making healthcare decisions at the time of signing.
Once the form is signed, keep a copy somewhere emergency responders can find it, get the identification bracelet, and make sure a copy goes into your permanent medical record.
One boundary worth being clear about: a DNR order under Act 193 is written for situations outside the hospital. It addresses CPR and nothing else. It does not speak to ventilators, feeding tubes, pain management, or any other treatment decision.
The DNR Identification Bracelet
The bracelet is how paramedics identify your order in a crisis. Michigan law requires the bracelet to display:
- The words “DO-NOT-RESUSCITATE ORDER,” printed as legibly as the bracelet size allows.
- The declarant’s name and address.
- The name and telephone number of the attending physician, if any.
Do not put a DNR bracelet on anyone who does not actually have a valid order behind it. Under MCL 333.1057, doing so is a misdemeanor punishable by up to two years in jail, a fine of up to $1,000, or both.1Michigan Legislature. Michigan Code 333.1057 – Identification Bracelet
When Someone Else Signs for the Declarant
Michigan has separate statutory tracks for people who cannot sign on their own behalf.
Minor children. MCL 333.1053b lets a parent execute a DNR order on behalf of a minor child. The form, signature, and witness requirements mirror the adult process but are tailored to the parent-child relationship.
Incapacitated adults with a guardian. MCL 333.1053a allows a court-appointed guardian to execute a DNR order on behalf of a ward.
Patient advocates. A patient advocate under Michigan’s Estates and Protected Individuals Code (MCL 700.5506) is not the same thing as a guardian. Whether a patient advocate can sign a DNR depends on the specific powers granted in the patient advocate designation document. If you are acting as someone’s patient advocate, read the designation carefully to confirm it covers DNR decisions before you try to sign one.
How to Revoke a DNR Order
You can revoke a DNR order at any time, by any method of communication that conveys your intent to revoke. Speaking, writing, or any other way of making your wishes known all count. The revocation takes effect the moment it is communicated to an attending physician, a peace officer, or emergency medical personnel.
Whoever receives the revocation then has specific obligations:
- For an oral revocation, the person must confirm back to the declarant that the order is revoked and record the time, date, place, and identity of the person revoking in the medical record.
- For a written revocation, the same time, date, place, and identity details go in the medical record.
- If the person receiving the revocation has possession of the DNR form or the identification bracelet, they must destroy it.
That last step is the one families most often skip, and it is the one that matters most in a crisis. A verbal revocation that never made it into the chart, with the bracelet still on the declarant’s wrist, will get the declarant exactly the resuscitation they changed their mind about. Paramedics act on what they see.
A physician, peace officer, or emergency medical worker who is told about a revocation and fails to act on it is not liable for damages unless the failure amounted to gross negligence or willful and wanton misconduct.2Michigan Legislature. Michigan Do-Not-Resuscitate Procedure Act – Revocation of Order
How a DNR Differs From MI-POST and an Advance Directive
Because a DNR only covers CPR, most people who want control over end-of-life care in Michigan end up looking at one or both of two companion documents.
MI-POST
MI-POST (Michigan Physician Orders for Scope of Treatment) was created under Public Act 154 of 2017 and is Michigan’s version of the POLST form used in other states. It is an optional one-page, two-sided medical order covering CPR, critical care interventions, and other treatment preferences. MI-POST is intended for people with serious advanced illness or frailty and must be signed by both the patient (or their representative) and a physician, nurse practitioner, or physician assistant.3Michigan Department of Health and Human Services. MI-POST
Like a DNR, MI-POST is a portable medical order that travels with the patient and is honored by emergency personnel. If a health professional has actual notice of both a DNR order and a valid MI-POST, MCL 333.1061a directs them to follow the most recently executed document.
Advance Directive and Patient Advocate Designation
An advance directive describes the medical treatments you do or do not want if you can no longer communicate. A Michigan Patient Advocate Designation (MCL 700.5506) names someone to make healthcare decisions for you; it requires two witnesses and becomes active only when you cannot participate in treatment decisions.
A standard advance directive generally cannot be acted on by EMTs in the field. That is the practical reason a DNR or MI-POST exists alongside it. The DNR gives first responders a direct, immediately actionable instruction. The advance directive and patient advocate designation guide longer-term treatment decisions once a physician is involved. You can have all three.
If a Valid DNR Order Is Ignored
If emergency personnel or a healthcare facility perform CPR on someone with a valid DNR order, the patient or the patient’s family may have grounds for legal action. The claims typically raised include:
- Medical negligence, for failing to check or honor the order.
- Battery, on the theory that CPR performed against documented wishes is unconsented medical contact.
- Breach of contract, where a written agreement with a facility covered end-of-life care.
- Violation of patient rights grounded in state or federal autonomy and informed consent protections.
Possible damages include compensation for physical pain from the unwanted resuscitation, medical expenses for treatment the patient never wanted, the patient’s emotional distress, and emotional trauma to family members who witnessed the intervention. These cases are difficult because they require proving that honoring the order would have produced a better outcome, which forces a court to weigh additional life against the patient’s expressed wish to forgo it. One more point worth knowing: under MCL 333.1064, no hospital, nursing home, or insurer in Michigan can require you to sign a DNR as a condition of care, admission, or coverage.