We do not prepare DNRs. Clients are required to obtain these from a medical professional.
What is a DNR? What are the Pros and Cons of Having One in Place?
A Do Not Resuscitate Directive (DNR) order is a medical directive that informs healthcare providers not to perform cardiopulmonary resuscitation (CPR) or other life-saving measures on a patient in the event of cardiac arrest or respiratory failure. The decision to have a DNR order in place should be made after careful consideration of the potential benefits and drawbacks. Here are some pros and cons of a DNR order:
Pros:
Respects Patient's Wishes: A DNR order ensures that a patient's wishes regarding end-of-life care are honored. It allows individuals to have control over their medical decisions, particularly if they do not wish to undergo aggressive and potentially futile resuscitation efforts.
Enhances Comfort: For patients with serious or terminal illnesses, a DNR order can help improve their quality of life by preventing unnecessary pain and suffering associated with aggressive interventions.
Promotes a Natural Death: Some people prefer a natural death without aggressive medical interventions. A DNR order aligns with this preference and allows patients to pass away peacefully, surrounded by loved ones.
Reduces Healthcare Costs: Avoiding futile resuscitation efforts can reduce healthcare costs associated with extended hospital stays and intensive interventions that may not lead to a meaningful recovery.
Supports Family Decision-Making: Having a DNR order can relieve family members of the burden of making difficult decisions during a crisis. It provides clarity and a legal basis for withholding resuscitation.
Cons:
Potential for Misunderstanding: DNR orders can be misunderstood, leading to conflicts among family members or healthcare providers. Miscommunication or differing interpretations of a patient's wishes can arise. Confirming you have signed a DNR in your Advanced Health Care Directive will help minimize confusion.
Emotional Distress: Deciding to have a DNR order can be emotionally challenging for both the patient and their loved ones. It may lead to difficult conversations and feelings of guilt or regret.
Limited Chance of Survival: The main drawback of a DNR order is that it limits the chances of survival in the event of a potentially reversible condition. While CPR and resuscitation efforts are not always successful, there are situations where they could save a life. If you are not suffering from a chronic or terminal condition, you may want to consider the drawback of having a DNR if the primary reason for having it is advanced age.
Ethical Dilemmas: Healthcare providers may face ethical dilemmas when they encounter a DNR order, especially if they believe there is a reasonable chance of a positive outcome with resuscitation. Balancing patient autonomy with the duty to save lives can be challenging.
Legal and Liability Issues: Healthcare professionals may be concerned about potential legal and liability issues if they follow a DNR order, especially if there are disagreements among family members or if the order is unclear or outdated.
Choosing to ignore a DNR is a serious decision. Most healthcare providers and institutions would weigh heavily upon this before choosing to ignore the patient's instructions. Again, stating you have signed a DNR in your Advanced Health Care Directive would help avoid this Ethical Dilemma. If you do not have a chronic or terminal condition, providing your Health Care Agent and local hospital with a Precatory Letter explaining why you have this in place would be best practice. Some individuals chose to keep this letter, their Advanced Health Care Directive, and contact information for their Health Care Agent(s) in the Glove box of their car or other easily accessible area.
In conclusion, a DNR order is a complex medical decision that should be made in consultation with healthcare professionals, taking into account a patient's values, prognosis, and overall medical condition. It's essential for individuals and their families to fully understand the implications and potential consequences of a DNR order and to communicate their wishes clearly with their healthcare team. Additionally, regular reviews and discussions about the DNR order are important to ensure it remains consistent with the patient's wishes and medical status.