What is a DNR order?

A “do not resuscitate order,” often shortened to DNR, tells healthcare providers that you don’t want to be resuscitated in the event of an emergency. In other words, you don’t want them to perform CPR if your breathing stops or your heart stops beating. A DNR order is signed by both you and your doctor, and is usually for patients with serious health conditions.

Since a DNR order provides specific instructions about your medical care, it’s often considered a type of advance directive.

What types of treatment do DNRs cover?

A DNR has a narrow focus: It only answers the question of whether to administer CPR when your heartbeat or breathing stops. CPR stands for “cardiopulmonary resuscitation.” It’s an emergency medical treatment used to try to restore blood flow and lung function. Among other things, CPR can involve:

• Mouth-to-mouth breathing
• Chest compressions
• Administration of controlled electric shocks to the heart (called “defibrillation”)
• Breathing tube insertion (called “intubation”)

If you have a DNR, you’re still able to receive other types of medical treatment and procedures from medical personnel. A DNR only covers resuscitation.

When is a DNR appropriate?

The decision to get a DNR is a personal one, and there aren’t any hard and fast rules for whether you should have one. Common reasons that people choose to get a DNR include:

• Religious or philosophical beliefs. Some people are morally or ethically opposed to resuscitation.
• Failing health. If someone is terminally ill or elderly and frail, they may wish to let nature take its course.
• No medical benefit. Those with severe health problems who probably won’t respond to treatment sometimes choose to obtain a DNR.
• Diminished quality of life. For those who are frail, CPR can be aggressive and result in injuries that cause additional pain.

How do you get a DNR?

Each state has its own particular requirements and paperwork. If you want a DNR, talk to your doctor. They’ll provide you with the proper form, fill it out with your input, and put it on file at your hospital.

Who should you give your DNR form to?

Make sure your healthcare providers, caregivers, and family members know you have a DNR and don’t want to be resuscitated. You should give a copy of your DNR to anyone who’s involved in your care, including:

• Your primary care doctor
• Your hospital
• Your healthcare agent (if you have a medical power of attorney)
• Loved ones who may be present during an emergency and can inform emergency workers of your wishes

You should also keep a copy of your DNR with you at all times, so medical personnel can find it in the event of an emergency. Your doctor may have suggestions for state-approved ID bracelets, dog tags, or wallet cards that you can keep on you.

Can you change your mind about your DNR?

Yes. You — or your healthcare agent or guardian — can revoke your DNR at any time by notifying your doctor, or by destroying the original form and all copies. If you decide to revoke your DNR, let your doctors, loved ones, and other caretakers know, so they’re aware of the change.

Living will vs. DNR: What’s the difference?

Living wills and DNRs are both legal documents that address potential future medical care. But they serve different purposes and are created in different ways.

In a living will, you outline your wishes about life-prolonging medical treatments in case you’re ever incapacitated and can’t communicate. You can create a living will by yourself, without the help or sign-off from your doctor. Living wills can cover a wide range of life-prolonging treatments, including blood transfusions, medications, breathing machines, dialysis, and more.

A DNR, on the other hand, deals only with the narrow question of whether you want to receive CPR. You can’t create a DNR on your own. In most states, your doctor must complete and sign the DNR for it to be legal. DNR orders can be used by first responders, while living wills cannot.

If you have a living will, do you need a DNR?

This depends on your level of health and your personal preferences. A living will is a good way to express your wishes in the event you become incapacitated. You can even include CPR preferences in your living will. But a DNR request within your living will may not always be legally binding on all medical professionals.

For example, in many states, emergency medical personnel — like first responders and paramedics — must provide CPR unless you have an official state DNR form, signed by a doctor, stating otherwise. If you don’t want emergency medical personnel to perform CPR, you may consider talking with your doctor about a DNR.

If you’ve created a medical power of attorney, do you need a DNR?

If you have a healthcare power of attorney, that means you’ve appointed someone to make healthcare decisions for you if you’re ever incapacitated. This person is called your healthcare agent. If you’re incapacitated, your healthcare agent could create a DNR for you. But if you’re sure you don’t want to receive CPR, completing a formal DNR in advance can be helpful. It provides guidance to your agent, and can be used by medical personnel if your agent isn’t present when a decision needs to be made.

Does a DNR guarantee you won’t be resuscitated?

There’s not a 100% guarantee that medical personnel will honor a DNR request. Generally, hospitals and other care providers will, especially if they know it exists ahead of time and can notify the staff. But emergency medical responders are usually called in expecting to revive or stabilize a patient, and they may not be aware of a DNR request. That’s why it’s important to share your preferences with the people you spend time with, and keep a copy of your paperwork easily accessible.

Is a DNR right for you?

Creating a DNR is a personal choice, and there’s no right or wrong answer to whether you should have one. Consider discussing your situation with your doctor and loved ones to determine what’s right for you.

DNR orders only state that you don’t want to be resuscitated. If you want to provide more guidance when it comes to your future healthcare wishes, you may consider creating an advance healthcare directive. You can create an AHCD for free with FreeWill.