Do Not Resuscitate (DNR) Orders
A do not resuscitate order is a form that notifies medical care providers, such as hospital staff, nursing home or assisted living facility staff, and paramedics, that no resuscitation efforts are to be made in the event the patient's heart or breathing stops. This is also referred to as a no code order, or abbreviated as DNR. Basically, do not resuscitate orders are used when the patient has a terminal condition and resuscitating the patient would do nothing more than briefly delay death and prolong discomfort.
A do not resuscitate order is typically signed by the patient's physician. In addition, depending on the state, it may also be signed by:
- the patient;
- the patient's health care agent if the patient is incapacitated; or
- the patient's court-appointed guardian who has the authority to make health care decisions.
This form is then posted in the patient's hospital or nursing home room, or somewhere in the patient's residence.
Example 1: Bill is 95 years old, is mentally competent, and is suffering from severe congestive heart failure. He is only expected to live, at most, a few more months. Bill decides that if his heart stops, there is no point in the hospital staff resuscitating him, only for him to be in discomfort for a few more weeks and have to go through another heart attack. Bill and his doctor sign a do not resuscitate order.
Example 2: Margaret is 82 years old and has late-stage Alzheimer's disease, leaving her bedridden with no quality of life. She has a health care power of attorney that appoints her daughter, Jean, as her surrogate. After consulting with Margaret's doctor, Jean decides that there would be no point in resuscitating Margaret so that she could continue in a vegetative state for a few more weeks or months. Jean and her mother's doctor sign a do not resuscitate order.