What Is a DNR Order? A Plain-Language Explainer for Families

If a doctor or nurse has asked you, or a parent, "Do you want CPR?" or "Have you thought about a DNR?", you're not alone in feeling unprepared. This page explains the terms in plain language so the conversation with the care team is easier.

Education only. Not medical or legal advice. This page doesn't recommend any choice. Decisions about CPR and DNR orders belong to the patient (or their legal decision-maker) together with their health care providers. Rules and forms vary by state. Facts below are drawn from MedlinePlus, the U.S. National Library of Medicine, unless another source is linked.

The short answer

A do-not-resuscitate (DNR) order is a medical order written by a health care provider. It tells providers not to perform CPR if the patient's breathing stops or their heart stops beating.

A DNR is specific to CPR. According to MedlinePlus, it does not contain instructions about other treatments, such as pain medicine, other medicines, or nutrition. Having a DNR does not mean "no care."

What CPR involves

CPR (cardiopulmonary resuscitation) is the treatment given when the heart or breathing stops. MedlinePlus lists that it may involve: - Pressing hard on the chest, and rescue breathing - Electric shock to try to restart the heart - Breathing tubes to open the airway and give oxygen - Medicines

Television tends to show CPR as quick and usually successful. In real life, how likely CPR is to work, and what recovery looks like afterward, depends a great deal on the person's health and situation. That's exactly the kind of question to ask the care team about the specific person involved.

If you do nothing, CPR is the default

In most settings, if a person's heart or breathing stops and there's no DNR order, the care team will attempt CPR. MedlinePlus puts it simply: if you want CPR, you don't have to do anything. A DNR is something you request; it doesn't happen on its own.

How a DNR order is made

• The person (or their health care agent) tells their provider what they want.
• The provider talks it through and, if appropriate, writes the order. In a hospital, it goes in the medical record.
• For home or other non-hospital settings, providers can explain how to get a form, wallet card, or bracelet so emergency responders can see the person's wishes. Standard forms may be available from your state's health department.

A DNR can be changed

A person with a DNR order can change their mind and ask for CPR. If that happens, tell the provider and care team right away, tell family and caregivers, and destroy old documents showing the DNR.

DNR, living will, health care proxy, POLST: what's the difference?

These terms get mixed up. In plain terms:

• DNR order: a medical order, signed by a provider, about CPR only.
• Advance directive / living will: a document you fill out yourself describing the kinds of care you would or wouldn't want if you couldn't speak for yourself. It's not a medical order by itself.
• Health care proxy (health care agent, durable power of attorney for health care): the person you name to make medical decisions for you if you can't.
• POLST (or MOLST, POST, and other names by state): a portable medical order form, signed by a provider, usually meant for people who are seriously ill or frail. It can cover CPR and other treatments. See polst.org for what's used in your state.

MedlinePlus suggests including DNR wishes in an advance directive and telling your health care agent and family about your decision.

If the person can't speak for themselves

According to MedlinePlus: if a provider already wrote a DNR at the person's request, family may not override it. If the person named a health care agent, that agent (or a legal guardian) can agree to a DNR for them. If no one was named, a family member may be able to agree to a DNR in some circumstances, but only when the person can't make their own decisions. State law shapes the details.

Questions you might bring to the care team

Writing these down ahead of time helps when emotions run high:

1. What's the current health picture, and what do you expect in the coming weeks or months?
2. If CPR were needed, how likely is it to help in this situation? What might recovery look like?
3. What would a DNR change about the care, and what would stay the same?
4. Are there other treatments we should be deciding about too, such as a breathing machine or hospital transfers?
5. Should we fill out a POLST form, and what does our state use?
6. Who do we call if we have more questions, or change our minds?

Talking about it as a family

• Start with values rather than procedures: what matters most to the person, what they fear, what a good day looks like.
• Let the person lead, if they can. If you're the decision-maker, the question is usually "What would they want?" rather than "What do I want?"
• It's okay for the answer to take more than one conversation.

If you'd like a guided workbook

We wrote a longer plain-language guide with worksheets for thinking this through and preparing for the conversation with the care team. It's educational only and doesn't recommend any choice.

• Is a DNR Right for Me (or My Parent)?: Paperback on Amazon · Printable on Etsy · Gumroad