Understanding DNR Orders

Do Not Resuscitate (DNR) orders tell hospital staff not to perform potentially life-saving measures, such as CPR, if the patient's heart and lungs stop working. A DNR order must be written by a doctor. This can only be done with the patient's or family's consent. If a patient has not written an advance directive, the family with the help of the healthcare team will decide on a DNR.

Writing a DNR Order

When might a DNR order be written? When a patient is near death, if recovery isn't likely, or if the treatment could cause more harm than good. Coma and terminal illness are instances when a DNR order might be used.

Irreversible Coma

In a coma, a patient does not respond to sight, sound, or touch. The heart and lungs could be working, but brain function is damaged due to trauma or disease.

Terminal Illness

In the last stages of heart disease, AIDS, cancer, and other illnesses, some patients don't want to prolong their suffering. If recovery isn't likely and quality of life is poor or getting worse, a patient or the family may agree to a DNR order.

DNR Orders and Hospice care

A hospice program can offer care during the final weeks of life. Hospice programs provide pain control and comfort care in the home or at special facilities. Hospice does not provide aggressive treatment. In fact, a DNR order will likely be discussed before a patient is admitted to hospice. A social worker or case manager may be able to help you arrange for hospice support.