DNR or CPR? Which is right for you?
A Do Not Resuscitate order, or DNR, is a legally binding physician’s order that states that no steps will be carried out to restore breathing or a patient’s heartbeat if they undergo respiratory or cardiac arrest. These orders are typically set up in advance before any emergency occurs.
Cardiopulmonary resuscitation, or CPR, is an emergency procedure that combines chest compressions often with artificial ventilation and is given to patients experiencing respiratory or cardiac arrest. This involves mouth-to-mouth breathing and compressing on a person’s chest. An electric shock may be given to restart the heart and breathing tubes may be used to open airways. In addition, certain medications may also be given to resuscitate a patient.
When a patient elects to be DNR, the DNR order is placed in their medical chart. A DNR order only affects whether the patient will be given CPR, but it does not outline the type of care one may choose to receive. A patient may choose to be DNR but may still elect to receive selective measures for care, such as IV antibiotics, IV hydration, artificial nutrition, or they may elect to receive comfort-focused care, which only focuses on symptom management and comfort care without the use of IV or tubes.
Every competent individual has the right to refuse life-saving medical treatment for any reason, and advance care planning can ensure this right is respected if a person becomes incapable of participating in their own care decisions. Thinking about end-of-life situations may be unpleasant, but it is important to start making decisions while you are still healthy. Advanced care planning helps your loved ones know which decisions you would make regarding your health if you become unable to communicate your needs and wishes. If your health takes a turn for the worse, or if you are in a tragic accident, it’s imperative that your healthcare providers, as well as friends and family, are aware of your preferences for health care. This is especially important when it comes to stopping medical treatments towards the end of life, such as in hospice care. An advanced directive is a simple way to relieve your loved ones from the worry, guilt, or regret that may come with making medical decisions on your behalf.
A DNR order may be right for you if you are opposed to the idea of being resuscitated, have religious objections, or worry that it may negatively impact your quality of life. CPR can save lives, but for people who are older or frail, CPR may cause broken ribs, brain damage, organ damage, or it may leave one unable to breathe without a ventilator. If you do decide to receive CPR, you do not need a DNR order and there is no need to do anything as CPR is the standard course of treatment when a person stops breathing or has no heartbeat.
Talk to your healthcare provider if you decide to have a DNR order in place. Your healthcare provider is required to follow your wishes and will fill out a form called Physician Orders for Life-Sustaining Treatment (POLST) to keep in your medical record.
If you get a DNR but later change your mind and decide you do want to be resuscitated, get in touch with your healthcare provider right away, inform your family and caregivers of your decision right away, and destroy any documents that include the DNR order to avoid confusion.