DNR

Do Not Resuscitate (DNR) is a legal order to withhold CPR (cardiopulmonary resuscitation) or advanced cardiac life support (ACLS) in the event that a patient's breathing or heartbeat stops. It is a critical aspect of medical ethics and end-of-life care, reflecting a patient's wishes regarding their healthcare and treatment in situations where they are unable to communicate their decisions.

Overview

A DNR order is created, or set up, based on a discussion between a patient (or their healthcare proxy or family members, in cases where the patient is unable to make their own decisions) and the healthcare provider. This decision is often influenced by the patient's overall health, their values and beliefs, and the likelihood of a meaningful recovery following resuscitation efforts.

Legal and Ethical Considerations

The legal status and implications of DNR orders can vary significantly between jurisdictions, but they generally require clear documentation to be recognized by healthcare professionals. Ethical considerations also play a significant role in the decision-making process for DNR orders, balancing the principles of autonomy, beneficence, non-maleficence, and justice.

Implementation

In a healthcare setting, a DNR order is documented in the patient's medical record and is communicated to all healthcare professionals involved in the patient's care. In some regions, patients may also wear a DNR bracelet or carry a DNR card as a means of informing emergency medical services (EMS) of their DNR status.

Controversies and Challenges

The implementation of DNR orders can sometimes lead to ethical dilemmas and controversies, particularly in situations where family members or healthcare providers have differing opinions on the best course of action for the patient. Additionally, there is ongoing debate regarding the clarity and scope of DNR orders, especially in relation to other forms of life-sustaining treatment.

See Also

• Advance healthcare directive
• Palliative care
• Patient autonomy
• Medical ethics