Q: What Is a Do Not Resuscitate (DNR) Order and how does it work?

A: A Do Not Resuscitate Order is a legally binding physician's order for a patient, which is signed by the treating doctor, that no steps will be taken to restart a person's heart when it stops or to get a person breathing again if the patient stops breathing.

A DNR order is normally a result of a person's advance healthcare directive, also known as the living will, which outlines the treatment measures to be taken to keep the person alive. The decision to not resuscitate a person must be made by the individual, if competent to do so, or by the person's agent for healthcare, on a living will or healthcare directive, if the person is not competent to do so. The patient or agent must ask for such an order.

The signed DNR order is placed in the patient's hospital chart. The family of the patient who does not want to be resuscitated often must remind the doctors and staff in a hospital about the order, because the first action doctors and nurses will take if a patient does stop breathing or their heart ceases to beat is to attempt resuscitation.

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The DNR order only works if the patient or the patient's family is clear with the doctors, and is able to be the patient's advocate in the care setting, otherwise it is automatic that resuscitation attempts will take place. In other settings, such as hospice care (care designed to keep someone comfortable in their last days for a dignified death, rather than trying to fix or save them during their last days), DNR orders are fully respected without coaching or advocacy by family.