Why a 'Do Not Resuscitate' order is not a 'Do Not Treat' order

Cultures · Published 3 October 2026 Swipe more like this →

In short: A Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) form is often misunderstood as a total withdrawal of care. In reality, it is a specific medical decision regarding one high-intensity intervention. Understanding the nuance between refusing a procedure and refusing treatment is vital for navigating end-of-life dignity.

DNACPR (also known as DNR or DNAR) specifically instructs healthcare teams not to attempt cardiopulmonary resuscitation if a patient's heart or breathing stops. CPR is a physically intense procedure involving repeated chest compressions, electrical shocks via a defibrillator, and artificial ventilation. Because these actions can cause significant trauma—including broken ribs, bruised tissue, and punctured lungs—the decision to forgo them is often made when the likelihood of a successful recovery is low or when the intervention would cause undue suffering.

The efficacy of CPR varies wildly depending on the environment and the patient's underlying health. Data shows that CPR succeeds in restarting breathing or heart function for only about 1 to 2 in 10 people. Success rates are notably higher in hospital settings (approximately 26% in 2017) compared to out-of-hospital settings (10% in 2018). Furthermore, survival chances drop significantly for patients with kidney disease, liver disease, or widespread infection, where survival is roughly half the average rate. For those in nursing homes, survival is often half to three-quarters of the average, though the presence of an Automated External Defibrillator (AED) can double those odds.

Crucially, a DNACPR form does not mean a patient loses access to all medical support. Patients continue to receive all other appropriate care, treatment, and support. While individuals with capacity can refuse CPR at any time, doctors may also initiate a DNACPR order if they believe the procedure would be futile or cause harm. This decision must be made on an individual basis; it is unlawful to apply DNACPR to groups based on age, disability, or race. Patients have the right to be informed of such decisions and can seek a second opinion if they disagree with a doctor's assessment.

General information, not professional advice. Spotted an error? Flag the card or see corrections and complaints.

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