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Do Not Resuscitate (DNR) Orders

By: Beth Morrisey MLIS - Updated: 24 Sep 2019 | comments*Discuss
 
Do Not Resuscitate Order dnr Order

Do Not Resuscitate (DNR) order are basically notes in a patient's file that they do not want to be resuscitated should their heart stop. Some people view DNR orders as akin to euthanasia and believe that patients who request this order are ensuring their own death. However the medical establishment views DNR orders as the patient's choice, though they do request that those considering DNR orders to discuss it with their family members. DNR orders may be requested for a variety of reasons, all of them designed to keep the patient from suffering further.

DNR Guidelines

Today there are multiple guidelines in place governing when a DNR order may be issued. These guidelines include if a resuscitation attempt is unlikely to be successful, if the patient himself (while of sound mind) has stated that he does not want to be resuscitated and this preference was written down somewhere, if the patient has a living will that states that he does not want to be resuscitated or if it is believed that resuscitating the patient would lead to a worse quality of life. However these are the instances in which a DNR order can be issued, there are no guidelines regulating when a patient can request a DNR order. This means that a patient can request not to be resuscitated at any time and this wish is recorded then it should be followed when needed.

NHS Trust Policies on Resuscitation

NHS Trusts also regulate their policies on the resuscitation of patients. To do so, all Trusts must have a policy on resuscitation that respects patients' rights as well as a non-executive director who is responsible for implementing the policy. This policy must be available for patients and their family members to review and it must be reviewed regularly by the Trust to ensure that it is still appropriate. Patients or family members who have never seen their Trust's policy should request a copy. Patients or family members who are concerned that a DNR order could be issued without consent should discuss this worry with hospital or Trust staff.

Discussing DNR Orders with Family

In theory, DNR orders are cut and dry but in practice these are emotionally charged decisions. DNR orders necessarily encompass life and death, and if families are not agreed about a DNR order for a loved one when then it can be an extremely difficult time when the order is followed. To avoid family problems, patients considering a DNR order should discuss the situation with their closest relatives. In fact, both the British Medical Association and the Royal College of Nursing have issued guidelines directing medical professionals to only issue DNR orders after the issue has been carefully considered by the patient and his or her family. While each individual will choose to hold this discussion in his own way, it is best to do so in a calm manner, by clearly stating why he wants the order, and in a private place where the family can have a truthful discussion. For their part family members should endeavour to remain calm, understand what is being said to them, and ask meaningful questions until everyone understands what is being decided.

Do Not Resuscitate (DNR) orders can be controversial, though for the most part if an individual has requested a DNR order their wishes are followed without question. Families should discuss DNR orders early so that there are no surprises should a loved one be in a position to need such an order.

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I live in the US and recently found out from a cousin that my brother in Wales had passed away and a neighbor was taking care of things. After contacting the coroners office he found out the date of death and the funeral home. The funeral home gave us the number of the person arranging the funeral and said that they had been paid from my brother's bank. We contacted the neighbor and he just filled us in the death date .We texted our address and phone number but no reply from him and he won't return our calls. What can we do
taffy - 24-Sep-19 @ 6:33 PM
My Dad passed away on 26th March andf there is no will as he has no property but he has a bank account with less than £10,000 and I need access to it to pay for the funeral etc. Do I need to arrange probate for this ?
GMJ - 2-May-19 @ 12:53 PM
I am 45 yes old with no serious illness but I do not want to be resuscitatedcan I insist on a DNR anyway?
Ali - 13-Jul-18 @ 4:40 PM
The hospital told me and my family about 2 years ago that they would not re suss my mum if she were to go into cardiac arrest she also has a pace maker. 1 year ago i was so upset i had a phone call from the hospital to get to the hospital ASAP as my mum was having a cardiac arrest. To my horror when i arrived they informed me that my mum was being resuscitated and i couldn't go in to see my mum they had been working on my mum for over 2-3 hours before we arrived. I found it absolutely disgusting that the paramedics wheeled her out in-front of me and my family still 3 people pumping her chest and blood coming from different parts of her body. I told them that she was NOT to be resuscitated that its on her file. They said the sticker was not on her file to say don't re suss. My mum had already passed away in the morning what the paramedics was getting a reading of was the pase maker. I would love to take this matter and complain but i don't know who to contact ?
lesley - 10-May-18 @ 10:25 PM
AGTX1 - Your Question:
My dad has terminal cancer & late stage dementia. He has partial sight, partial hearing & mobility issues alongside feacal incontinence. He is cared for at home by mum and home help which he wants& needs but his quality of life is poor. Can we put a DNR in place on his behalf? I truely believe it would be cruel to resuscitate him in a medical environment.

Our Response:
You would need to discuss this health professionals as described in the above article.
FacingBereavement - 9-Mar-18 @ 2:48 PM
My dad has terminal cancer & late stage dementia. He has partial sight, partial hearing & mobility issues alongside feacal incontinence. He is cared for at home by mum and home help which he wants& needs but his quality of life is poor. Can we put a DNR in place on his behalf? I truely believe it would be cruel to resuscitate him in a medical environment.
AGTX1 - 8-Mar-18 @ 6:26 PM
Please could somebody confirm whether there legally has to be 2 healthcare profesional signatures to any DNR form, I am finding only 1 signed and blank box on the majority I deal with on a daily basis at work, and am getting conflicting info from my managers and GPs, etc. My training states there should be 2, but I am finding it difficult to find a hard copy of this info. Any advice would be good as I am concerned at the possible implications that could occur.
smudge - 18-Jun-13 @ 6:46 PM
I'm a Social Worker working with Adults with Learning Disabilities. I recently found out that one of my client's file has a DNR in place. He lives in long term resdiential care. However, he does not have the capacity to make this decision. Can this decision be made on his behalf? No MCA has been done as far as I'm aware.
Janine - 5-Feb-12 @ 12:36 PM
How would a paramedic at the scene of an accident or a collapse in the street know that I have registered for DNAR? Does anyone sell bracelets to show this?
Valerie Sellars - 23-Dec-11 @ 10:50 PM
my dad has a dna form in his hospital bed file. this has never been discussed with him or his family. he is 85 years old and is in a good state of mind. surely he should have been consulted about this
HELP - 10-Dec-11 @ 1:46 AM
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