An Overview of DNR Orders

Aug 05, 2019

Because the Do Not Resuscitate (DNR) order is often encountered by Volunteer Guardians in their course of volunteering, it is worth discussing.

A DNR order indicates that a person – usually with a terminal illness or other serious medical condition – will not receive cardiopulmonary resuscitation (CPR) in the event his or her heart or breathing stops. A DNR order is written by a physician after discussing the burdens and benefits of CPR with the patient or the patient’s surrogate decision maker. 

Did you know that there are two different types of DNR orders that can be chosen?  The first is the DNR Comfort Care (DNRCC) and the other is the DNR Comfort Care- Arrest (DNRCC-Arrest).  A DNRCC order requires that a person receive any care that eases pain and suffering, but no rescuitative measure to save or sustain life.  This type of order is generally regarded as proper for a person with a terminal illness, short life expectancy, or with little chance of surviving CPR. On the other hand, a DNRCC-Arrest order requires that the patient receive standard medical care until the time he or she experiences a cardiac or respiratory arrest.

Even though CPR can save lives, sometimes individuals may prefer a DNR order.  This can be due to a variety of reasons, such as the fact that CPR often involves more than just chest compressions and mouth-to-mouth resuscitation.  CPR can also include the use of powerful drugs or electric shock to start the heart beating again or may require the insertion of a breathing tube. Also, even if a person is resuscitated, he or she may suffer painful injuries during the CPR process or may be left in a worse condition than before.

Remember that the ward’s physician is required to explain the different types of DNR orders to the guardian. So, if you have questions about the DNR order, be sure to ask. 

Finally, keep in mind that each ward is unique in their medical prognosis and physical condition. Therefore, a DNR order may not be suitable in all situations.  When possible, getting to know the ward’s feelings about such end-of-life decisions will also be helpful should that decision need to be considered.