Medical Decisions

What a DNR Actually Commits You To

A do-not-resuscitate order covers one moment and one intervention. It is narrower than most people think, and it does not say what happens before that moment arrives.

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What happened

A form is put in front of someone, usually at admission, usually at the worst possible time to read carefully. It asks a yes or no question about resuscitation, and the person answering has to decide what the word covers.

Why it matters

A do-not-resuscitate order addresses one moment: cardiac or respiratory arrest. It says what should not be attempted when the heart stops. It is not a general instruction to withhold care, it does not refuse pain relief, antibiotics, surgery, or food and water, and it says nothing at all about the hours or days before that moment arrives.

People sign one believing it does more than it does, and people refuse one believing it does more than it does. Both mistakes come from the same place: the form asks about an event, and the person answering is thinking about a situation.

What you can do about it

Ask what the order covers and what it does not. Ask what happens in the situations it does not reach, because those are the ones more likely to arrive. And if the answer matters to you, put it somewhere that will be found by whoever is in the room, which is a different problem from deciding.

Filed under explainerdnrhospitals

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