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Is a Do Not Resuscitate Order Needed for End-of-Life Care?

by Viki Kind, End-of-Life Expert
December 04, 2014

Question: What is a DNR (Do Not Resuscitate Order) and is it needed for end-of-life care?

Answer: A DNR (Do Not Resuscitate Order) is when you decide, with your doctor, that you don’t want to receive CPR (Cardiopulmonary Resuscitation.) Cardio stands for heart, pulmonary stands for lungs and resuscitation means to revive from death. Making the decision about CPR vs. DNR is just one of many end-of-life choices a person can make ahead of time. 

Now you might be asking yourself, “Why would anyone not want to be brought back to life?”  Well, the reality of CPR working and bringing a person back to life in a good condition is very different from what you see on television.  This is why in many hospitals, the doctors don’t say DNR and instead say DNAR (Do Not Attempt Resuscitation) because the chance of CPR actually working and bringing the person back to life is very limited. 

On television shows like ER, CPR brings the patient back to life about 75 percent of the time (Diem, Lantos and Tulsky 1996), when in real life it only works, at best, 17% of the time for those who are healthy (Peberdy, et al. 2003). In situations where someone is seriously ill and in the intensive care unit, the chance of success may be as low as 0-1% percent. 

Television also misleads patients by letting you think that a person will be healthy enough to go home about 67 percent of the time (Diem, Lantos and Tulsky 1996). In reality, if CPR is able to bring the patient back to life, the chance of this person going home with good brain function is about 7 percent (Kaldjian, et al. 2009). For other patients, they may survive CPR but they won’t ever be able to leave the hospital.

Before you make a decision about CPR, there is a lot to learn about what is involved and what your specific chance for recovery would be.  For a more detailed discussion about CPR, go to https://www.youtube.com/watch?v=eDM-Sw-fibo and speak with your doctor.  

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Viki Kind is a clinical bioethicist, professional speaker, and hospice volunteer. Her book, The Caregiver’s Path to Compassionate Decision Making: Making Choices For Those Who Can't,” guides families and professionals through the difficult process of advocating for those who can no longer speak for themselves. She has recently launched a DVD that includes a template to create a quality-of-life statement.

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