What Is A DNR And Should You Consider One?
A Do Not Resuscitate (DNR) order is a legal and medical directive that tells healthcare providers not to perform CPR or other life-saving measures if a patient’s heart or breathing stops. These measures can include chest compressions, intubation, defibrillation, or use of a ventilator. People often choose a DNR to avoid unnecessary suffering, maintain dignity, or reduce emotional and financial strain on loved ones.
Between 2016 and 2023, DNR orders increased by 36%, with most being signed by individuals aged 65 or older, many of whom are Medicare recipients. Terminal illness, concerns about quality of life, or a belief that death is a natural process often influence the decision to decline resuscitation.
Contrary to how CPR is portrayed in the media, its real-world effectiveness is limited. The American Red Cross reports survival rates of only about 10% outside hospitals and 21% within. CPR can also cause significant harm, such as broken ribs or brain injury due to lack of oxygen. Similarly, procedures like intubation and mechanical ventilation come with risks including infection, throat damage, and loss of independence.
A key benefit of the DNR process is that it typically involves informed consent. Patients are encouraged to discuss the potential outcomes of resuscitation with their doctor, making it easier to align decisions with personal values. DNRs are also reversible and can be temporarily suspended, such as during surgeries.
However, DNRs are sometimes misunderstood. While they only apply to specific life-saving interventions, healthcare providers may mistakenly assume that a patient with a DNR wants no treatment at all. This can lead to reduced care, even for unrelated conditions. Studies show that patients with DNRs can experience worse outcomes due to such assumptions.
In complex cases — such as patients with cognitive decline or multiple serious illnesses — a DNR alone may not be enough to guide care. For example, a person may have refused aggressive treatment but can no longer express their wishes, leaving decisions up to family members who may disagree.
To ensure that medical care aligns with a person’s goals, a DNR should be part of a broader plan. Advance directives like living wills and healthcare power of attorney documents can provide clearer guidance. A living will outlines what treatments a person wants, while a healthcare power of attorney allows them to designate someone to make decisions on their behalf.
Together, these tools help preserve autonomy, reduce suffering, and ensure care reflects an individual’s values.
Read more: Benefits and Drawbacks of Do Not Resuscitate (DNR) Orders
