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Do Not Resuscitate (DNR)

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If your heart or breathing stops and you can't speak for yourself, emergency personnel will assume you consent to treatment. They are legally obligated to do everything they can to restart your heart and lungs ["cardiopulmonary resuscitation" (CPR)] unless you execute a Do Not Resuscitate Directive ("DNR").

A DNR [(also known as "Do Not Attempt Resuscitation" (DNAR)] lets you express the wish that you do not want emergency treatment to restart your heart and lungs if your heartbeat or breathing stops. To put it bluntly, a DNR means you do not want to be brought back from the dead. A DNR order does not and should not affect any other treatment decisions. For instance, a person with a DNR order can be put on a respirator if he or she just has difficulty breathing. This is not the same as a person who has stopped breathing.

There are two kinds of DNR:

  • A DNR order in a hospital chart. This DNR is used in hospitals. It is permitted in all states
  • A non-hospital DNR which is permitted in many states. The latter document is known as a Out-of-Hospital DNR form. It keeps unwanted CPR or intubations from occurring in your home or during transport to or from a hospital.

There are steps to take to be sure your wishes are complied with, including posting a copy of the DNR where it will be seen in case of an emergency. For non-hospital events, the question of whether a DNR is legal or whether emergency responders will comply with it can be avoided by letting all caretakers know that if you stop breathing, not to call 911 until it is too late to admnister CPR.

For practical purposes, assume that your DNR has to by signed by a doctor as well as by yourself.

We recommend that people who complete a DNR execute a new one each time you enter a health care facility or change health care providers. Using  the facility's or provider's form will save time during an emergency. It avoids their having to take the time to decide whether your DNR meets the guidelines they set for a DNR directive.

Neither a Living Will or a Health Care Power Of Attorney substitutes for a DNR. They will not be honored in the subject situation.

NOTE: All too frequently a DNR is not honored because medical personnel in Intensive Care Units (ICUs) are not aware they exist or are too busy to read them. If you appoint a person to act as your health care Proxy, he or she can be sure medical personnel are alerted to your DNR wishes - and help enforce them. (To learn about the documents which appoint a health care Proxy, click here.) If you want to be absolutely certain that your DNR wishes are honored, tatoo or write with indelible ink the letters DNR on your chest.

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