Do Not Resuscitate Orders (DNR)

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    What is a do-not-resuscitate order?

    Can I request a DNR order?

    What are the advantages and disadvantages of CPR?

    Is my right to request or receive other treatment affected by a DNR order?

    Is my consent required for a DNR order?

    How can I make my wishes about DNR known?

    If I request a DNR order, is my physician bound to honor my wishes?

    If mediation has not resolved the dispute within 72 hours, your physician must enter the order or transfer you to the care of another physician.


     

    What happens if I do not have the capacity to decide for myself?

    You are presumed by law to be mentally capable of deciding about CPR unless two physicians, or a court, determines that you no longer have the capacity to make the decision. You will be informed of this determination if you are able to understand it, and no DNR order will be written if you object. 


    If I do not have the mental capacity to make a decision about CPR and do not leave instructions in advance, who will decide?

    If you lose the capacity to decide and did not leave advance instructions, a DNR order can be entered only with the consent of someone chosen by you in advance, or by a family member or another person with a close personal relationship to you. The person highest on the following list will decide on your behalf:

    • a person you have selected to decide about resuscitation;
    • a court appointed guardian (if there is one);
    • your closest relative;
    • a close friend.

     

    How can I select someone to decide for me?

    If you are a patient in a hospital or nursing home, you can appoint a person orally with two witnesses present.

    You can also appoint someone during or in advance of hospitalization by stating your wishes in writing and signing that statement with any two adults present. The adults must also sign your written statement. 


     

    Under What circumstances can a family member or close friend consent to a DNR order?

    A family member or close friend can consent to a DNR order only when you are unable to decide for yourself and:

    • you have a terminal condition; or
    • you are permanently unconscious; or
    • CPR would be medically futile; or
    • CPR would impose an extraordinary burden on you given your medical condition and the expected outcome of resuscitation.

    Anyone deciding for you must base the decision on your wishes, including your religious and moral beliefs, or if your wishes are not known, on your best interest.


     

    What if members of my family disagree?

    They can ask for the matter to be mediated. Your physician will request mediation if he or she is aware of any disagreement among family members. 


     

    What if I lose the capacity to decide and do not have anyone who can decide on my behalf?

    A DNR order can be entered only if two physicians conclude that CPR would be medically useless or if a court approves the DNR order. It would be best if you discussed the matter with your physician and left instructions in advance.


     

    Who can consent to a DNR order for children?

    A DNR order can be entered in the record for a patient under the age of 18 only with the consent of the patient's parent or guardian. If the minor has the capacity to decide, the minor's consent is also required for a DNR order.


     

    What happens if I change my mind after I consent to a DNR order?

    You or anyone who consents to a DNR order on your behalf can withdraw that consent at any time by informing your physician, nurses or others of the decision. 


     

    What happens to a DNR order if I am transferred from a nursing home to a hospital or vice versa?

    The health facility where you are sent can continue the DNR order but is not obligated to do so. If the order is not continued, you or anyone who decided on your behalf will be informed and can request that the order be entered again.

    New York State Department of Health