What is a DNR order and when does it apply?
By CRYSTAL BAI •
The short answer: A DNR (Do Not Resuscitate) order is a medical order that instructs healthcare providers not to perform CPR if a person's heart stops or they stop breathing. It applies in hospitals, nursing homes, and — with a separate out-of-hospital DNR — in home or community settings. It covers CPR only, not other medical treatments.
What a DNR covers and what it does not
| A DNR covers | A DNR does not cover |
|---|---|
| CPR (chest compressions) | Pain management |
| Defibrillation (electric shock to restart heart) | Antibiotics or other treatments |
| Emergency intubation to restart breathing | IV fluids or nutrition |
| Comfort measures and hospice care |
A DNR specifically addresses resuscitation attempts. If you want broader instructions about ventilators, feeding tubes, or artificial nutrition, those are covered in a living will or POLST form.
In-hospital DNR vs. out-of-hospital DNR
These are two different documents:
- In-hospital DNR: Signed by your physician and placed in your medical chart. Instructs hospital staff not to attempt resuscitation.
- Out-of-hospital DNR (OOH-DNR): Required if you want your wishes honored outside a hospital. Without this document, emergency medical services (EMS) are legally required to attempt resuscitation when called.
The out-of-hospital DNR varies by state name (POLST, MOLST, MOST, DNAR) but serves the same function. It must typically be signed by your physician and kept accessible at home.
Who should have a DNR
A DNR is appropriate when:
- CPR is unlikely to be successful given your underlying health condition
- You have a terminal illness and resuscitation would not align with your goals of care
- You are enrolled in hospice care
- Surviving CPR would mean a quality of life you find unacceptable
A DNR is not appropriate for everyone. For a healthy person, CPR after an unexpected cardiac event can be lifesaving. The decision should be made in conversation with your physician based on your specific health status.
How to get a DNR
- Talk to your primary care physician or specialist about whether a DNR aligns with your health situation and goals
- Request both an in-hospital DNR order be placed in your chart and an out-of-hospital DNR form
- Keep the out-of-hospital DNR visible at home — many people tape it to the refrigerator, which is where EMS is trained to look
- Give copies to family members, your healthcare proxy, and any facilities where you receive regular care
Can a DNR be reversed?
Yes. You can revoke a DNR at any time while you are mentally competent. Tell your physician, update your medical chart, and destroy the physical document.