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The Merck Manual--Second Home Edition logo
 
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Chapter 9. Legal and Ethical Issues
Topics: Introduction | Competency and Capacity | Informed Consent | Confidentiality and Disclosure | Advance Directives | Surrogate Decision Making | Do-Not-Resuscitate Orders | Management of Property
 
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Do-Not-Resuscitate Orders

The do-not-resuscitate (DNR) order placed in a person's medical record by his doctor informs the medical staff that cardiopulmonary resuscitation (CPR) (see Section 24, Chapter 299) should not be performed. This order has been particularly useful in preventing unnecessary and unwanted invasive treatment at the end of life.

Doctors discuss with patients the possibility of cardiopulmonary arrest, describe CPR procedures, and ask patients about treatment preferences. If a person is incapable of making a decision about CPR, a surrogate may make the decision based on the person's previously expressed preferences or, if such preferences are unknown, in accordance with the person's best interests.

A DNR order does not mean "do not treat." Rather, it means only that CPR will not be performed. Other treatments (for example, antibiotic therapy, treatment for discomfort or pain, transfusions, dialysis, use of a ventilator) may still be provided if needed.

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