Every patient, including those advanced in age, retains the right to decline medical treatment and interventions if they choose to. One of the ways this is achieved is by getting a do-not-resuscitate order (DNR).
Essentially, a DNR is an order that specifically informs healthcare service providers not to attempt to provide cardiopulmonary resuscitation services in case of medical emergencies. As such, this order is prepared before an actual emergency occurs, and is written by a qualified healthcare provider under instruction by the patient or their legally recognized healthcare proxies. Since the DNR order is specifically written to decline cardiopulmonary resuscitation, it only covers interventions such as the following.
Chest compressions
Pressing on the chest in an attempt to restart the heart would be withheld under a DNR order. This basic form of CPR is used during cardiac arrest, but the DNR order respects the person’s decision to not undergo this procedure.
Electric shock to restart the heart
An electric shock, known as defibrillation, used to restart the heart during cardiac arrest would not be performed if a DNR order is in place. This method aims to restore a normal heart rhythm but would be avoided if the person has opted out of resuscitation measures.
Airway management
Efforts such as mouth-to-mouth breathing and the use of breathing tubes to open the airway and assist with breathing would be avoided under a DNR order. Mouth-to-mouth breathing is used when a person is not breathing, and breathing tubes are typically used during severe respiratory failure to maintain an open airway.
Medications to restart the heart or improve circulation
Medications used to restart the heart or improve circulation would not be administered under a DNR order. These drugs are often given in emergencies to stabilize the heart or blood pressure, but the DNR order would prevent their use if the person has chosen to decline aggressive resuscitation efforts.
If you are considering a DNR order, legal guidance may be important to help ensure that your wishes are properly documented and understood by all parties involved, including healthcare providers and family members.
