Category: 

What is a Do Not Resuscitate (DNR) Order?

Hospital staff and nurses will still work to make a DNR patient comfortable through hydration with intravenous fluids.
A patient with a DNR may be given supplemental oxygen, but not put on a ventilator.
An advance directive tells the doctor how much medical intervention to give the patient during his or her terminal illness.
Intubation is considered a lifesaving measure included in a DNR order.
A patient may request a DNR if he or she ends up in a coma.
Article Details
  • Written By: Mary McMahon
  • Edited By: Bronwyn Harris
  • Last Modified Date: 28 October 2014
  • Copyright Protected:
    2003-2014
    Conjecture Corporation
  • Print this Article
Free Widgets for your Site/Blog
The US Post Office uses a mail boat to deliver to other ships on the Detroit River, and it has its own zip code: 48222.  more...

November 27 ,  1978 :  Harvey Milk and San Francisco Mayor George Moscone were murdered.  more...

A Do Not Resuscitate (DNR) order is a type of advance directive which indicates that a patient should not be offered CPR or other lifesaving measures in the event of cardiac arrest or other medical emergencies. Typically, a DNR is requested by or for a patient who is terminally ill, to avoid potentially painful and invasive procedures. Very elderly patients or patients in other circumstances may also request a DNR.

There are a number of types of DNR order, and it is helpful to know the difference between them, especially if you are considering a DNR request for yourself. While most people associate a DNR with cardiopulmonary resuscitation (CPR), other lifesaving measures including the administration of IV drugs, intubation to secure an airway, and use of defibrillator paddles may also be used in a hospital environment. Some of these measures are traumatic and invasive, and they may not always be effective, if a patient is seriously ill.

Under a basic DNR order, none of these measures will be provided to a patient who is in respiratory or cardiac arrest. However, hospital staff and nurses will still work to make the patient comfortable through the administration of oxygen, movement of the patient, and hydration with intravenous fluids. The intention of a DNR is not to kill a patient, but to keep him or her comfortable when death approaches.

Ad

Ideally, a patient should request a DNR with his or her doctor, setting up what is known as a “DNR specific.” This type of DNR is much more extensive, indicating specific desires for certain conditions. For example, a patient may request a DNR if he or she ends up in a coma, but not if he or she experiences a heart attack while awake. By being specific in an advanced directive, the patient can be sure that his or her wishes are followed in the event of a major medical catastrophe.

In a patient cannot make medical decisions and an advanced directive has not been dictated, someone else must take responsibility, such as a close relative or somehow in whom the parent has invested the power of attorney. People who are put in this position should think carefully about the wishes of the patient, especially if he or she is experiencing multiple organ failure or brain death. It may be helpful to remember than brain dead patients can potentially donate their organs, thereby saving lives even if they are no longer able to enjoy life.

Ad

More from Wisegeek

You might also Like

Discuss this Article

anon323286
Post 14

My mom died this week. I will never have peace with this as I have deep reservations over whether she was killed or suffered. Granted she was old, but her family lived well into their 90's and some to over 100. She had respiratory issues but only secondary to common issues in elderly. Her last hospitalization was due to a gastric-infection which had cleared. Over and over this hospital badgered her to sign a DNR. She said she had a living will and did not sign, and repeatedly saying she wanted to be intubated if needed.

It was not a simple issue of saying no. Nurses sat and told her how easy it would be, how morphine would ease her anxiety as she struggled for air. Doctors chided her about cracking her ribs if they needed to do CPR. We persevered in rejecting it because seven years previous we had the same sales pitch.

Mom recovered and was moved to a rehab/home for short term therapy to strengthen her legs. Within six hours, we received a call saying she was dead, that she had "difficulty breathing" and the home had ambulated her back to the hospital, where they say she "willingly had signed a DNR.”

We had no recourse. She died as we knew she didn't want to -- in an ER, with people who didn't care, alone with strangers, with no call or opportunity to hold her during her last moments. Their need to not resuscitate overruled our need to comfort her in her final hour.

It is sad to see the medical field desensitizing elderly death. It reminds me of the movie "Logan's Run".

anon291310
Post 12

At one hospital, my Dad was full code. His liver was having problems and the doctor recommended changing his code to DNR. I refused. The doc sighed and said that she'd try to reduce his medication and see what happened. After reduction, my Dad's liver bounced back. So, I agree that the DNR is "sometimes" (too often!) used as an excuse to let the patient die.

anon272043
Post 8

Some of you people obviously do not understand the trauma that some people go through when we as medical professionals are performing life saving measures on someone who is going to die anyway.

It is everyone's personal decision whether or not they want life saving measures or not. Why would I want my 80 year old mother put through the trauma of chest compressions (which in the elderly can cause rib fractures quite easily) or having a breathing tube shoved down their throat?

I think in some cases, it is more important for the person to be comfortable and go with dignity than it is for the family to be selfish and want to keep them alive on machines.

anon254725
Post 7

People should never want to have a dnr. They are a convenient way for nasty medical staff to get rid of a person who they do not want to treat. It is absolutely no help for a patient.

anon222612
Post 6

DNRs are so bad and should be banned. That is how we lost our relative. They tried to kill her with drug over doses to try to get her to go into cardiac arrest but since she had a DNR, she was not allowed to get cpr. That did not work since she was so strong and healthy but they gave her a curable fungal skin infection when she was in the hospital getting a minor surgery (which was not necessary it just was done to improve her lifestyle). She was never treated for the curable hospital skin infection that they gave her.

She went into sepsis shock while in sepsis shock they purposely gave her the wrong medicine for the fungal infection which only got worse. As she was dying from this curable infection they refused to give her oxygen. They just made her and her family suffer by killing her. The family will continue to suffer from this DNR murder.

DNRs and euthanasia just need to be banned forever. Both very deadly and horrible.

anon108770
Post 5

Laws are different in different in every state. however, the general rule is that only a doctor can order a DNR with consent of patient, spouse, then majority of consent of children. If you have proof that a DNR was ordered and you didn't sign it, that in itself is a problem. if you ask for notes and you have something missing, consult an attorney.

anon99460
Post 4

my son who is 34 years old had a DNR put on him by one doctor because my son had lung damage. we as a family didn't want this but as my son was in a coma the hospital gave us no choice. my son would have wanted a DNR on him, but my son did live. he has lung damage but he's alive.

A top consultant told us that the doctor had no rights to put a DNR on our son and he said the doctor was in the wrong but my son's notes are now missing. how can we prove this?

serenity9now
Post 3

How does the Good Samaritan Law affect people who knowingly performs CPR on a person with a doctor's order for a DNR for example someone who is terminally ill and receiving hospice services.

anon10101
Post 2

Does the coma have to last a certain time and must it be absolute that the patient die as apposed to the possibility it given some might come out of the coma?zpue

anon9465
Post 1

Can a DNR be lifted?

Post your comments

Post Anonymously

Login

username
password
forgot password?

Register

username
password
confirm
email