Do Not Resuscitate (DNR) Order

What is a do not resuscitate order?

A do not resuscitate order is a physician-authorized medical directive that communicates your decision to decline CPR in the event your heart or breathing stops. It is one of several advance care planning documents that allow you to make your medical wishes known before a crisis occurs so that doctors, nurses, and emergency responders are not left guessing.

CPR includes a range of interventions: chest compressions, electric shock (defibrillation), breathing tubes, and mechanical ventilation. While CPR can be lifesaving in some situations, it is often unsuccessful in patients with serious illness or advanced age, and it can cause significant physical trauma. A DNR order allows you to weigh those realities in advance and make a deliberate, informed choice.

To be valid, a DNR order must be signed by the patient (or the patient's legal representative, such as a healthcare power of attorney agent) and by a licensed physician. The completed document is placed in the patient's medical record and, in many states, should also be kept in a visible location at home, such as on the refrigerator, so that emergency medical technicians can find it quickly.

A DNR order takes effect the moment it is properly signed and placed in your medical record. It does not require a separate activation step or a terminal diagnosis.

DNR orders are sometimes called "no code" orders within hospital settings, or "allow natural death" (AND) orders—a term some healthcare providers prefer because it frames the directive around comfort and dignity rather than refusal of treatment. All three terms describe the same legal and medical instruction.

State law governs the exact form, witness requirements, and scope of a DNR order. LegalNature's state-specific forms are built to meet the requirements of all 50 states and the District of Columbia.

Types of DNR orders

The type of DNR order that applies to you depends on where you receive care, when the DNR is created, and the scope of resuscitation decisions you want to address. LegalNature's DNR form can be applied generally and are state compliant in all 50 states and the District of Columbia.

In-Hospital DNR Order An in-hospital DNR instructs the hospital care team not to perform CPR during an inpatient stay. It is documented in your hospital chart and applies only within that facility. If you are discharged, the order does not automatically travel with you.

Out-of-Hospital DNR Order An out-of-hospital DNR—sometimes called a prehospital DNR—applies outside of hospital settings. It directs emergency medical technicians (EMTs) and first responders not to initiate CPR if called to your home, a nursing facility, or another community location. This is the form most relevant for patients managing serious illness at home or in hospice care.

DNR order vs. living will: what's the difference?

A DNR order and a living will are both advance care planning documents, but they serve different functions and operate through different legal mechanisms.

A living will expresses your general wishes about end-of-life care; a DNR order is a specific, immediately enforceable medical instruction about CPR.

A living will does not replace a DNR order, and a DNR order does not replace a living will. Many people complete both documents as part of a broader estate and healthcare planning strategy. The living will communicates your values and broader treatment preferences; the DNR order gives care providers a clear, actionable instruction they can follow without waiting for further interpretation.

If you have named a medical power of attorney agent, that person may have authority to request a DNR order on your behalf if you become incapacitated, but only if your state law and your POA document permit it. Consulting with an attorney is recommended if you have questions about the scope of your agent's authority.

Do not resuscitate help guide

A do not resuscitate order is one of the most personal documents in advance care planning, and one of the most misunderstood. This guide synthesizes the key points from this page and addresses terminology and distinctions that frequently cause confusion.

What a DNR Order Actually Does (and Doesn't Do)

A DNR order does one thing: it instructs care providers not to perform CPR if your heart or breathing stops. It does not suspend all treatment, accelerate death, or override your other medical wishes. Every other intervention—pain relief, surgery, antibiotics, comfort care—remains fully available unless you have separately addressed it in a living will or POLST form. The document's narrow scope is a feature, not a limitation. It allows you to make one high-stakes decision clearly without affecting anything else.

"DNR," "No Code," and "Allow Natural Death" — The Same Instruction

You may encounter different terms depending on where you receive care. "DNR," "no code," and "allow natural death" (AND) all describe the same medical instruction: do not attempt CPR. Hospital staff often use "no code" in clinical settings; some providers and patient advocates prefer "allow natural death" because it emphasizes comfort and dignity rather than refusal. All three terms carry the same legal and medical weight when documented in a properly executed order. If your physician or care facility uses different language than you expect, ask for clarification. The underlying instruction should be identical.

In-Hospital vs. Out-of-Hospital: The Distinction That Matters Most

The single most important practical question about a DNR order is where it applies. An in-hospital DNR lives in your chart and governs your care team within that facility only. An out-of-hospital DNR travels with you; it is the form that emergency responders, home health aides, and nursing facility staff can act on outside of a hospital. If you are managing serious illness at home or enrolled in hospice, an out-of-hospital DNR is the operative document. Many patients need both. LegalNature's document is applicable to both situations.

How a DNR Fits Into a Complete Advance Care Plan

A DNR order works best as part of a coordinated set of documents. Here is a useful way to think about the relationship:

• Your last will and testament addresses what happens to your property after death.
• Your medical power of attorney designates who speaks for you if you cannot speak for yourself.
• Your living will communicates your broader preferences about life-sustaining treatment.
• Your DNR order gives care providers one specific, immediately actionable instruction about CPR.

No single document does all of these jobs. Each fills a distinct gap, and the absence of any one of them can leave your family or care team without the guidance they need.

State Law Governs the Details

DNR requirements are not uniform across states. The required form, witness rules, physician authorization process, and EMS recognition standards all vary. A DNR executed in one state is not automatically valid in another. If you move, spend extended time in a second state, or are admitted to a facility in a different state than where your DNR was signed, work with your physician to execute a new state-compliant order. LegalNature's platform generates state-specific DNR forms for all 50 states and the District of Columbia to make that process straightforward.