Do-not-resuscitate (dnr) orders

[Luis Fok]

A do-not-resuscitate (DNR) order placed in a person’s medical record by a doctor informs the medical staff that cardiopulmonary resuscitation (CPR) should not be attempted. Because CPR is not attempted, other resuscitative measures that follow it (such as electric shocks to the heart and artificial respirations by insertion of a breathing tube) will also be avoided. This order has been useful in preventing unnecessary and unwanted invasive treatment at the end of life. The success rate of CPR near the end of life is extremely low. (See also Overview of Legal and Ethical Issues in Health Care.)
Doctors should discuss with seriously ill patients the possibility of cardiopulmonary arrest (when the heart stops and breathing ceases) in light of their immediate medical condition, describe CPR procedures and likely outcomes, and ask patients about treatment preferences. If a person is incapable of making a decision about CPR, an authorized surrogate may make the decision.
A DNR order does not mean