Who can create a Do Not Resuscitate (DNR) order?

A Do Not Resuscitate (DNR) order is a specific medical order indicating that a patient does not wish to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest. The primary individuals authorized to create or request a DNR order are either the patient themselves or their designated representative, such as a healthcare proxy or legally appointed guardian. This is rooted in the principles of autonomy and informed consent, which emphasize that patients have the right to make decisions regarding their own medical care, including end-of-life preferences.

While other healthcare professionals may be involved in the discussions surrounding a DNR order or can implement it once in place, the actual authority to initiate or formally create the order lies with the patient or their legal representative. Family members may support the patient’s wishes or discuss their preferences, but they cannot unilaterally create a DNR order without the patient's consent or legal designation as a representative. Furthermore, having a lawyer involved is not a requirement for establishing a DNR order, which focuses more on the medical and personal wishes of the patient.