Clients sometimes use the terms Living Will, DNR, and POLST interchangeably, but each document serves a different purpose. This white paper explains those differences and why our office typically prepares a Living Will as part of an estate plan, while DNR and POLST decisions should be made in consultation with the client’s treating medical provider.

1. What is a Living Will?

A Living Will, sometimes called an advance directive or healthcare directive, lets you state your wishes about medical treatment before a crisis occurs. It applies if you cannot speak for yourself. It often addresses whether you would want life-sustaining treatment, such as a ventilator or artificial nutrition, if you are in a terminal condition, persistent vegetative state, or similar end-of-life circumstance. It may also address pain management and comfort care. For many clients, the main goal is simple: they want to be kept comfortable, but they do not want treatment used only to prolong the dying process once physicians determine that the end of life is near. A Living Will is not a medical order. It is guidance for loved ones and medical providers.

2. What is a DNR?

A DNR (Do Not Resuscitate) directive is much narrower. It tells healthcare providers not to perform CPR, chest compressions, defibrillation, or similar resuscitation if your heart stops or you stop breathing. In Arizona, the pre-hospital DNR form is generally used outside the hospital setting. It must be completed in the required form and signed by the appropriate parties, including a medical provider.

  • Quick comparison:
Living Will DNR
Scope Broad — many scenarios Narrow — cardiac/respiratory arrest only
Who creates it You (with witnesses/notary) A physician signs it
When it applies Anytime you lack capacity The moment your heart or breathing stops
Where it matters most Hospitals, care facilities, any setting Wherever you are — including home

A Living Will may express that you would not want CPR in certain end-of-life circumstances, but a DNR is the medical order that tells emergency medical personnel not to begin resuscitation.

3. What is a POLST?

Arizona also recognizes a more detailed medical-order form called POLST, which stands for Physician Orders for Life-Sustaining Treatment. A POLST is usually for a person who is seriously ill, medically frail, or approaching the end of life. Unlike a Living Will, a POLST is meant to travel with the patient and give clear, immediate instructions to emergency responders and healthcare providers.

4. Why the physician’s role matters

This is the key difference. A POLST is a medical order, not just a statement of preference. A physician, nurse practitioner, or physician assistant must discuss the patient’s goals of care, consider the medical situation, and sign the form with the patient or authorized decision-maker. Because it is a medical order, healthcare providers can follow it directly. It can also be updated if the patient’s condition or wishes change.

A POLST covers more than whether to perform CPR. It may address:

  • CPR — whether resuscitation should be attempted if the patient has no pulse and is not breathing
  • Level of medical intervention — whether treatment should focus on comfort, limited interventions, or full treatment
  • Artificial nutrition — whether feeding tubes or similar measures should be used when the patient can no longer eat safely

For example, a POLST can state whether to attempt resuscitation, whether to use a breathing tube, whether to transfer the patient to a hospital, and whether care should focus mainly on comfort at home or in hospice.

5. Who should consider a POLST?

  • Have a serious illness, advanced frailty, or are nearing the end of life
  • May face medical decisions where emergency providers need immediate treatment instructions
  • Have had a meaningful conversation with their physician about their goals for care

A POLST is not usually needed by healthy adults. Most healthy adults should focus on advance directives, such as a Living Will and Healthcare Power of Attorney. A person with advanced illness, repeated hospitalizations, significant frailty, or hospice-level concerns should ask the treating physician or other authorized medical provider whether a POLST or DNR is appropriate.

6. Practical takeaway

For most estate-planning clients, the Living Will is the right planning document. It explains the client’s values and end-of-life wishes before a crisis occurs. A DNR or POLST is different because it gives medical orders for specific treatment decisions, usually when the client is seriously ill, medically frail, or nearing the end of life. Our role is to explain these differences, prepare the Living Will as part of the estate plan, and encourage clients who may need a DNR or POLST to speak with their personal physician or other authorized medical provider.

This white paper is general information and not specific legal or medical advice. Please ask your lawyer and physician questions until you are satisfied that you understand which document is appropriate for your circumstances.