Full Definition

A Do Not Resuscitate (DNR) order is a physician-written medical order that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient experiences cardiac arrest (heart stops) or respiratory arrest (breathing stops). Unlike advance directives (which express preferences), a DNR is an actionable medical order in the patient’s medical record.

CPR in hospitalized or facility-residing elderly patients has outcomes that many people do not realize: survival rates for in-hospital CPR in older adults are typically 10–20%, and survival to discharge with intact neurological function is far lower, particularly in those with serious illness, dementia, or frailty. For many seniors with advanced illness, CPR is unlikely to provide meaningful benefit and may cause additional suffering.

A DNR order does not mean withdrawing other medical care or comfort measures. A patient with a DNR still receives medications, treatments, comfort care, and all other medical interventions except CPR. A DNR order is also not equivalent to “giving up” — it is a clinical decision about the appropriateness of one specific intervention.

In Texas, DNR orders in healthcare facilities differ from Out-of-Hospital DNR (OOH-DNR) orders. The OOH-DNR is a standardized Texas form signed by a physician that instructs EMS not to attempt resuscitation in a home, assisted living, or other non-hospital setting. The OOH-DNR must be immediately available and visible when emergency services arrive.