It’s a familiar drama-filled television scene. First, a patient’s heart stops. Then, a medical team rushes in to perform CPR and other life-saving measures to bring the patient back to life.
A do-not-resuscitate (DNR) order informs medical staff that you do not want them to use life-saving techniques on you. This means medical caregivers won’t attempt to restart your heart if it stops beating.
A DNR order is essential to consider during advance care planning. It’s one document you may want to include when preparing end-of-life documents for yourself or a loved one.
What is Advanced Care Planning?
The goal of advance care planning is to let your wishes be known. When you cannot communicate to those around you, these legal documents let others know how you want to be cared for and what type of medical interventions you are and are not okay with.
There are several documents you should obtain during advance care planning. In addition to a DNR, other important documents you may want to include are a:
- Living will
- Durable power of attorney for health care
- Organ donation
- Physician Orders for Life-Sustaining Treatment (POLST) or Medical Orders for Life-Sustaining Treatment (MOLST)
What is a DNR?
A do-not-resuscitate order is a legal document that lets medical personnel know you don’t want them to use invasive emergency techniques to keep you alive. Techniques include:
- Cardiopulmonary resuscitation (CPR)
- Artificial breathing tubes
- Electric heart shocks
- IV medication used during cardiac arrest (like epinephrine, amiodarone, vasopressin, and atropine sulfate)
Every competent individual has the right to refuse life-saving medical treatment regardless of age or medical diagnosis. But typically, DNR orders are obtained by people in poor health and receiving treatment in a hospital or skilled nursing facility.
If you or a loved one wants to avoid invasive emergency medical care, it is important to complete this order. We encourage you to speak with your healthcare provider to thoroughly discuss the implications of deciding to move forward with a DNR.
Why is it important to have a DNR?
When you can’t communicate your preferences, having your wishes spelled out in a legal document is a gift to yourself and your loved ones. It ensures life-saving techniques aren’t used on you if you don’t want them to be, and your family doesn’t have to guess what you would or wouldn’t want. They already know, thanks to the DNR.
Keep in mind that people with a terminal illness have a lower likelihood of surviving life-saving techniques like CPR. And if they do survive, they often sustain injuries such as broken ribs. Therefore, it is common for individuals with a terminal illness to obtain a DNR.
How to Obtain a DNR
The process for obtaining a DNR varies from state to state. You can find your state’s DNR form on the health department’s website or discuss obtaining a DNR with your healthcare provider. In some states, your provider must sign the document, and it must be notarized.
Inform your healthcare power of attorney or trusted loved one of the completed DNR order. Make sure they are clear on your wish not to be resuscitated.
Keep a copy of the DNR with your other advance directives and a copy on your fridge, in your wallet, and in the car. This way, emergency personnel see it before beginning CPR. Ask your doctor to file it in your medical records as well.
Other resources that may help you obtain a DNR include:
- Trusted family member
- Social worker
- Healthcare provider
- Estate attorney
Can I Change My Mind After Obtaining a DNR?
Yes. You can easily reverse your DNR. To reverse your DNR, you should destroy the DNR documents. Also, inform your medical caregivers and family members that you are revoking your DNR order.
How is a DNR Different From a POLST or Living Will?
A POLST, living will, and DNR are all legal documents communicating the medical care you want at the end of life or in an emergency situation. They’re essential to have in place ahead of time if you cannot share those wishes yourself. Though they are similar, these three documents are different. Here's how —
- POLST: A Physician Orders for Life-Sustaining Treatment (also sometimes called a MOLST) involves a physician-initiated discussion with individuals who have a terminal illness. This patient-physician discussion results in a document that addresses the patient’s wishes regarding CPR, hospitalization, and the level of care they desire.
- Living will: Unlike a POLST, you don’t need to be diagnosed with a terminal illness or have a conversation with a doctor to create a living will. The legal document spells out medical treatments you would and would not want to be used to keep you alive and your preferences for other medical decisions.
- DNR: A Do-Not-Resuscitate (DNR) order is a legal document that lets medical personnel know you don’t want them to use invasive emergency techniques to keep you alive. Anyone can obtain a DNR, but it is typically obtained by someone with an advanced or end-stage illness.
Putting together advance care documents can give you peace of mind. Start a conversation with your loved one about advance care planning using our guide.
- “Advance Care Planning: Health Care Directives.” National Institute on Aging, 15 January 2018, www.nia.nih.gov/health/advance-care-planning-health-care-directives
- Irving, Shae. “Do-Not-Resuscitate Orders.” NOLO. www.nolo.com/legal-encyclopedia/do-not-resuscitate-orders.html
- Morrow, Angela. “Overview of Do Not Resuscitate Orders.” Very Well Health, 04 February 2022, www.verywellhealth.com/hands-off-do-not-resuscitate-113238
- Sabatino, Charles. “Do-Not-Resuscitate (DNR) Orders.” Merck Manual. May 2021, https://www.merckmanuals.com/home/fundamentals/legal-and-ethical-issues/do-not-resuscitate-dnr-orders