In this month’s journal club episode, we tackle a topic every EMS educator and clinician wrestles with: how do you honor a patient’s end-of-life wishes when they call 911? We unpack a structured review of U.S. EMS protocols and the wide variation in what counts as a valid Do Not Resuscitate (DNR) order, from physician-signed forms to bracelets, POLST-style documents, and even verbal orders. We’ll discuss how these differences can lead to moral distress and affect goal-concordant care, and why understanding the nuances of DNR documentation matters for field providers, system leaders, and anyone who wants to ensure patient wishes are respected in the out-of-hospital setting.