Do Not Resuscitate

Do not resuscitate
Intervention
DNR form used in Virginia
Synonyms	Do not attempt resuscitation, allow natural death, no code
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Do not resuscitate (DNR), also known as no code or allow natural death, is a legal order written either in the hospital or on a legal form to withhold cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS), in respect of the wishes of a patient in case their heart were to stop or they were to stop breathing. "No code" is a reference to the use of "code" as jargon for "calling in a Code Blue" to alert a hospital's resuscitation team. The DNR request is usually made by the patient or health care power of attorney and allows the medical teams taking care of them to respect their wishes. In the health care community, allow natural death (AND) is a term that is quickly gaining favor as it focuses on what is being done, not what is being avoided. Some criticize the term "do not resuscitate" because of the implication of important information being withheld, while research shows that only about 5% of patients who require CPR outside the hospital and only 15% of patients who require CPR while in the hospital survive. Patients who are elderly, are living in nursing homes, have multiple medical problems, or who have advanced cancer are much less likely to survive.

A DNR does not affect any treatment other than that which would require intubation or CPR. Patients who are DNR can continue to get chemotherapy, antibiotics, dialysis, or any other appropriate treatments.

Other terms and abbreviations for this order are used in different countries. DNR (Do Not Resuscitate) is a common abbreviation in the United States, Canada and the United Kingdom. It may be clarified in some regions with the addition of DNI (Do Not Intubate), although in some hospitals DNR alone will imply no intubation. Clinically, the vast majority of people requiring resuscitation will require intubation, making a DNI alone problematic.

Some areas of the United States and the United Kingdom include the letter A, as in DNAR, to clarify "Do Not Attempt Resuscitation." This alteration is so that it is not presumed by the patient or family that an attempt at resuscitation will be successful. Since the term DNR implies the omission of action, and therefore "giving up", some have advocated for these orders to be retermed Allow Natural Death. New Zealand and Australia, and some hospitals in the UK, use the term NFR or Not For Resuscitation. Typically these abbreviations are not punctuated, e.g., DNR rather than D.N.R.