Health and Medical

A UK Guide To The ‘Do Not Resuscitate Order’ and How DNR Forms Work

A UK Guide to the 'Do Not Resuscitate Order' and how DNR forms and decisions work.

What Is The DNR (Do Not Resuscitate) Order and How Does Work In The UK?  

A Do Not Resuscitate (DNR) order is a legal process in which a patient stipulates on their file that a doctor is not required to resuscitate a patient in the event of their heart stopping. The DNR order is often used to prevent patients suffering from negative effects which resuscitation may cause.

The typical situations in which it is appropriate not to resuscitate are:

  • when there is no benefit to the patient
  • when the benefits are offset by the burdens
  • when it will not restart the breathing or heart

Ethicality

DNRs are not considered controversial unless they are abused. In fact, they are often regarded as a form of passive euthanasia. Passive euthanasia happens when a patient passes away because the medical professionals either don’t do something necessary to keep the patient alive, or when they stop doing something that is keeping the patient alive.

DNRs are intended to stop patients suffering unnecessarily from the negative effects that resuscitation can trigger: brain damage, broken ribs and other fractures, ruptured spleen.

Proper use of Do Not Resuscitate Order

The British Medical Association and the Royal College of Nursing have issued guidelines which state DNR orders should only be asserted following a thorough discussion with patients or, in the event they are no capable, their family.

These conversations can often be difficult, however it is stated that medical professionals accept that this is no reason why discussions should not take place.

Guidelines

The UK medical profession has fairly open guidelines for circumstances in which a DNR order may be applied:

  • if a mentally competent patient has repeatedly declared or recorded the fact that she or he does not want to be resuscitated
  • if a patient’s state of health is in a position where resuscitation is unlikely to be a success
  • if there is advanced notice or a living will in which the patient has stated they do not want to be resuscitated
  • if the patients quality of life will be poor as a result of resuscitation

NHS Trusts, in the UK, must ensure:

  • an agreed resuscitation policy that respects patients' rights is in place
  • a non-executive director is recognised to oversee execution of policy
  • the policy is readily available to patients, families and carers
  • the policy is put under audit and frequently examined