DNR: (Do Not Resuscitate)

Before trying to define the term DNR (Do Not Resuscitate) or review what it means, it might be helpful to first define what the term resuscitation means.

What is Resuscitation?

Many people may define or envision resuscitation as either giving mouth-to-mouth emergency breathing or shocking someone with electric paddles.

MedlinePlus (2026) states that resuscitation is not simply one action or event. Instead, the act of resuscitation involves a series of interventions that are done in a sequential manner.

The different types of actions and the sequence of resuscitative interventions used depends on whether your heart has stopped beating, whether your lungs have stopped breathing, or whether both your heart and lungs have stopped functioning.

Consequently, resuscitative interventions may include the following actions:

A: Mouth-to-mouth breathing.

B: Chest compressions.

C: Electrical shock to restart the heart or override a lethal heart rhythm.

D: Insertion of breathing tubes into a person’s airway.

E: Administration of supplemental oxygen.

F: Use of medicines for either respiratory failure or cardiac arrest.

                                                                                      (MedlinePlus, 2026)

What is a DNR?

DNR: Defining Do Not Resuscitate 

Now that we know what the term resuscitation means, how would the term DNR (Do Not Resuscitate) be defined or described?

According to Vranick et al. (2022), unlike other advance directives such as a living will which merely discusses a person’s medical wishes, the DNR (Do Not Resuscitate) is a physician’s order that is legally recognized by a vast majority of healthcare providers within the United States. This physician's order conveys a person’s wish to refuse resuscitation efforts if the person is found to be without a heartbeat or has a cessation of respirations.

In simple terms, a DNR (Do Not Resuscitate) simply means that if you are found unresponsive, without a heartbeat, and without respirations (Breathing), healthcare providers will not do any of the following: 

A. Healthcare providers will not attempt closed cardiac compressions on your chest.

B. Healthcare providers will not attempt cardioversion (electric shock to restart your heart).

C. Healthcare providers will not use medications in an attempt to restore breathing or a heartbeat.

D. Healthcare providers will not use airway tubing or mechanical airway ventilator support if you are not breathing.                                                                                                                                                                                                                                          (Vranick et al., 2022)

Evolution and Integration: DNR as part of POLST Orders

It has been argued by Jennings et al. (2022), that as the delivery of healthcare has progressed and evolved, so too has there been an advancement in care planning options. Advance Directives of today may now involve more complex decision making than simply expressing the desire regarding your DNR status preference. Some states now follow a more comprehensive list of healthcare directives that are available to those receiving medical treatment.

The POLST (Physician Orders for Life-Sustaining Treatment) represents a set of potential advanced directive orders agreed to by you and your physician. This directive is a set of physician orders that will not only address and document your DNR status preference, but it now may include additional life-sustaining measures such as IV fluid therapy, artificial means of nutrition or blood transfusion therapy. 

                                                                                                                                                     (Jennings et al., 2022)

POLST (Physician Orders for Life-Sustaining Treatment)

The DNR document is similar to the POLST document in that they are both agreed upon by the patient, the Power of attorney for healthcare or the Healthcare surrogate decision maker and signed by the patient’s physician. The difference between a DNR (Do Not Resuscitate) and a POLST (Practitioner Orders for Life-Sustaining Treatment) lies with the scope of orders each document contains. The DNR is narrow in scope and conveys the wishes and physicians order which refuses cardiopulmonary resuscitative interventions only.

The POLST form has a much broader scope of healthcare orders that are chosen and signed off by a physician. The POLST not only includes specific orders that clarify DNR orders, but they may also include either acceptance or refusal of IV fluid therapy, artificial means of nutrition, blood transfusion therapy and other life-sustaining measures. 

It is important to keep in mind that the POLST is not always followed globally or even in some parts of the United States.

For further information, click on the green banner below to examine the official Illinois DNR/POLST for yourself.

                                                                                                                                                      (Solari et al., 2025)