What Is A Do Not Resuscitate order?
A do-not-resuscitate order (DNR), also known as no code or allow natural death, is a legal order, written or oral depending on country, indicating that a person does not want to receive cardiopulmonary resuscitation (CPR) if that person's heart stops beating. (Wikipedia)
These forms can be added to patients medical notes, as an instruction that should the patient stop breathing, or their heart stops, resuscitation will not be attempted. This decision is sometimes made by the patient or family, but on occasions is made by medical staff without anyone else being informed.
The intention of a Do Not Resuscitate order is to avoid painful or unpleasant procedures which could be pointless or with little guarantee of a successful outcome. More details...
If the decision is made solely by medical staff it can cause distress if not handled sensitively, especially if it appears to have been done without any consultation with the patient or their family/carers. Under current guidelines the patient (if capable of understanding and making a decision) should be consulted, if not, next of kin/legal guardian, family or carers should be consulted.
Sample Forms for NHS Staff etc
NHS - Sample forms for NHS Staff etc - click here.
Various forms to download & print as required.
If you would like to upload a copy of your own hospitals DNR form, please use the Contact Form.
If you are a medical professional your views and comments are welcome.
All submissions credited to the provider (if a name or identity is stated)
It's not always possible or worthwhile, CPR and it's side effects.
If you decide against resuscitation;
What can you expect? Many of us spend our last hours in hospital in recent years, meaning death has become hidden from the majority of people. Our ancestors had to deal with all aspects at home, but we are now usually protected from an event which will happen at some time to every one of us. More info here.....
How can you cancel a DNR instruction?
What can you do if you think a Do Not Resuscitate notice has been added unfairly? Or perhaps you simply change your mind about one that was already agreed?.
Contacting the doctor/s who signed the original order to agree removal of the notice should be sufficient. Keep in mind that any other semi-independent service may have their own copy (e.g. a care home) and may need to be updated on the situation.
Annoying but true, it is ultimately up to qualified medical staff such as doctors. If the doctors decide that a DNR instruction would be in someone's best interests your only further recourse would be to ask for a second opinion from a different doctor. Sadly this isn't an automatic right - it's up to the doctor concerned!
Under current guidelines the person the DNR order applies to should be consulted (if capable), or if unable to make sound judgement themselves, next of kin/family/legal guardian or carers should be involved.
Cases of DNR Misuse
Once again, numerous stories make the headlines - notices added without any consultation, doorstep visits to 'sign up' pensioners, NHS 'frailty team' looking for DNR customers etc. etc.
It sometimes seems once you reach 65 (or are disabled) NHS policy is to regard patients as expendable - is it the patients best interest at heart or a cynical cost saving move?
Here are a few random news articles on this subject:
Daily Mail : The Guardian : Daily Mail(2) : Max Pemberton : BBC News
It seems people with learning disabilities are also considered disposable now:
Fury at ‘do not resuscitate’ notices given to Covid patients with learning disabilities - The Guardian 13th Feb 2021
Some 508 'do not attempt resuscitation' (DNAR) decisions made since March 2020 were not agreed in discussion with the person or their family, a report found.
BBC News report 18th March 2021
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Do Not Resuscitate : Do Not Attempt Resuscitation : Not For Resuscitation : Allow Natural Death : End Of LifePlan : Liverpool Care Pathway : Supportive Care Plan :DNR : DNAR : LCP : DNAR Orders : Resuscitation Guidelines : Palliative Care : Dying Peacefully