What is required for a DNR/DNI to have legal weight?

• A. Original or certified copy and signed by physician and patient/surrogate.
• B. Tattoo
• C. Verbal statement by any person
• D. A nurse's note

Answer: (A)

A DNR/DNI has legal weight only when it is a formal, written order that is authenticated in the medical record. The essential elements are a document that is original or an officially certified copy, and it must bear the signatures of both the physician and the patient or the patient’s legally authorized surrogate. This written form provides clear, verifiable consent and medical authority, so clinicians can rely on it across settings and over time.

A tattoo cannot function as a valid medical order because it lacks authenticating signatures, date, and physician accountability. A verbal statement by someone or a nurse’s note likewise does not constitute a binding, authoritative directive; they lack the formalization and legal standing of a signed written order.