A Do-Not-Resuscitate (DNR) order is a medical instruction telling healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's heart stops beating or they stop breathing. It is a specific, physician-signed order — not simply a preference statement — and it has immediate legal effect in any healthcare setting where it's present.
What Is CPR, and Why Does a DNR Matter?
CPR is a set of emergency procedures designed to manually pump blood when the heart stops. In hospital settings, it may include chest compressions, electric shocks (defibrillation), and breathing tubes. CPR is depicted positively in popular culture, but the reality is more complicated: for many seriously ill patients, CPR has a low success rate and may involve significant physical trauma, sometimes resulting in broken ribs, brain damage from oxygen deprivation, or days on a ventilator — outcomes that some patients consider worse than a peaceful death.
For people with terminal illness, advanced age, or serious chronic conditions, a DNR order may reflect a choice to let death occur naturally rather than aggressively intervene.
How Is a DNR Different from a Living Will?
A living will is a document you write yourself expressing your preferences. A DNR is a physician's order — it carries immediate medical authority, doesn't require interpretation, and is actionable by any provider in any care setting.
A living will can express a desire not to be resuscitated, but to make this preference immediately effective across all healthcare settings, that preference needs to be translated into a DNR order by your physician. This is similar to how a POLST form works — it converts your wishes into medical orders.
Who Should Consider a DNR?
A DNR is appropriate to consider when:
- You have a terminal illness with a limited life expectancy
- You have advanced age and significant frailty
- CPR is unlikely to be effective given your medical condition
- Your values prioritize comfort and dignity over extension of life
A DNR is not typically appropriate for younger, healthy individuals who have a reasonable chance of surviving and recovering from a cardiac emergency.
How to Get a DNR Order
A DNR is initiated through a conversation with your physician. If you want a DNR, discuss your wishes with your doctor — explain your values, your understanding of your prognosis, and your preferences. Your physician will then write the order.
Once signed:
- The order should be kept in a highly visible location at home (many states provide bright orange or brightly colored forms for this reason)
- A copy should be in your medical record
- If you're transferred between care settings, the order needs to travel with you or be re-issued in the new setting
Can a DNR Be Reversed?
Yes. A DNR order can be revoked at any time by the patient. If your wishes change, simply tell your physician and ask them to update your orders.
DNR vs. DNI
You may also encounter a "DNI" (Do-Not-Intubate) order, which specifically instructs providers not to insert a breathing tube. You can have a DNR without a DNI, or request both.
For the full context on advance healthcare planning, see our complete guide to advance directives.