Do not resuscitate orders (DNRs) are frequently mistaken for a Health Care Proxy (HCP). A HCP allows you to name someone to make health care decisions if you cannot do so yourself. You may provide written directions about medical treatment and end-of-life care within the HCP or communicate those wishes verbally to your chosen agent.
The HCP is typically prepared as part of estate planning by an attorney or may be provided during hospital admission if the patient is competent. For validity, an HCP must be signed and dated by the person naming the agent and witnessed by two unrelated adults over age 18.
- Confusion is common: a DNR is a physician’s medical order, not a Health Care Proxy that names a decision-maker.
- An HCP can be prepared during estate planning and requires two adult witnesses; a DNR must come from a licensed provider.
- A DNR only limits CPR and resuscitation steps. It does not restrict other medical care or treatment.
- Clear planning saves families time and stress during emergencies. Read on to understand what documents you need and why timing matters.
DNR Meaning and Medical Purpose
Unlike the HCP, a DNR is a medical order written by a physician or health care provider. It tells providers that the patient does not want CPR if breathing stops. The dnr meaning is simply this medical instruction. Understanding what does do not resuscitate mean is important when reviewing care preferences.
Patients who sign DNR orders often have chronic conditions such as Chronic Obstructive Pulmonary Disease and may experience respiratory failure or pneumonia that could require resuscitation.
Reasons Patients Choose DNR Orders
Some patients complete a DNR after experiencing resuscitation and deciding they do not want CPR performed again. Others choose a DNR when they believe they are approaching end-of-life care and prefer to avoid aggressive life-sustaining treatment.
The decision to sign a DNR should be made with full understanding of medical condition, diagnosis and prognosis.
Physician Requirements for Writing DNR Orders
A doctor will only issue a do not resuscitate order after discussing medical wishes with a mentally competent patient. If the patient cannot make decisions, the physician will speak with the patient’s health care agent or family depending on circumstances.
A completed DNR directs health care providers not to:
- Perform mouth-to-mouth resuscitation
- Use defibrillators to restart heart rhythm
- Insert breathing tubes or use mechanical ventilation
- Administer medications meant to restart breathing or heart function
- These instructions apply specifically to resuscitation care and do not restrict other medical treatment.
DNR Documents, Living Wills and Medical Records
A DNR may be carried in wallet size or worn as a medical identification bracelet. It should be kept in a visible location in the home for emergency medical personnel. In hospital settings, the DNR becomes part of the medical record.
A living will often accompanies a DNR. It allows a patient to state that they do not want to be kept alive using extraordinary medical measures if they are brain dead, in a coma with no recovery potential or in similar medical situations.
Legal Planning Considerations
Attorneys can prepare advance planning documents such as HCP, living wills, power of attorney forms and HIPAA authorization forms. However, attorneys cannot prepare a DNR order. A DNR must be issued by a licensed medical provider after medical consultation.
Understanding what does do not resuscitate mean helps families and patients make informed care decisions.
