Help for Carers > Legal matters > Do Not Resuscitate order

Do Not Resuscitate order

Do Not Resuscitate orders (DNRs), are orders written onto a patient’s medical file that he/she does not wish to be resuscitated should his or her heart stop. People who care for others with grave health problems need to understand what they are, why and when they are issued, how to alert others to them and what it means to respect a loved one’s DNR.

A loved one’s DNR order can be a hard thing to accept. Understanding what DNRs are, how and why they are issued, how best to alert others to these orders, and what it means to respect DNRs are all important for those caring for the seriously ill.

The purpose of a DNR order is to prevent unnecessary suffering to the person who has gone into cardiac arrest. DNRs may also come into use if it is believed that resuscitation would be unsuccessful.

Issuing Do Not Resuscitate Orders

The guidelines of both the British Medical Association and the Royal College of Nursing require that a patient or his/her family must be consulted prior to a DNR order being issued. Everyone involved should have a chance to find out what resuscitation would require, the risks of the resuscitation process and how the patient’s quality of life could be adversely affected if he/she is successfully revived. Following such discussions, DNRs may be issued if:

The patient has a Living Will or Advance Notice that he/she would not like to be resuscitated.

The (mentally competent) patient has repeatedly stated that he/she opposes resuscitation.

The patient’s health suggests that he/she would not survive a resuscitation attempt.

It is believed the patient’s quality of life would be a lowered as a result of resuscitation.

Alerting others to a loved one’s DNR

It is highly unlikely that all of a patient’s loved ones will be involved in the decision to issue a DNR, which means that at some point the decision will need to be explained to others. Alerting others to the DNR may be best while the patient is mentally competent and can act on his or her own behalf to let people know that this is his or her preference. If this is impossible, then having someone who was involved in the decision explain how and why it was made, might be an alternative idea. Once others understand why the patient desired a DNR and how his or her life could be impacted if a DNR was not issued, they may well accept the reasoning in the decision.

Respecting a loved one’s DNR

Respecting a loved one’s DNR can be a challenge in the face of conflicting emotions. If a desire for a DNR order is written down, either in a formal Living Will or informal message to loved ones, it will help to confirm that this is the patient’s sincere desire. Speaking with medical staff about the DNR may also be a good way for loved ones to put worries to rest and better respect why their loved one has chosen this order.

To obtain a Do Not Resuscitate order, the cared-for person (if he/she is mentally competent) should talk to their GP. Alternatively, the carer can talk to the cared-for person’s GP on their behalf.

For further information about Do No Resuscitate Orders see the Living Wills website: www.respectourwishes.com (go to the FAQs section).


Taken from: TheCarer, Daresbury Point, Manor Park, Cheshire (Aug 2011)