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Do not resuscitate (DNR) forms and CPR decisions

DNR forms are used by doctors to communicate that a decision has been made not to attempt CPR.

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What is a DNR (do not resuscitate) form?

DNR (do not resuscitate) forms are used by doctors to communicate that a decision has been made not to attempt CPR (cardiopulmonary resuscitation).

They are a helpful way to protect people from being given CPR inappropriately.

Doctors use the official term DNACPR (do not attempt cardiopulmonary resuscitation), and the forms are also sometimes called DNAR (do not attempt resuscitation).

This page is for the public. We also have specific DNACPR guidance for healthcare professionals.

How DNR (do not resuscitate) decisions are made

If a doctor starts a conversation with you or a relative about DNR forms, this means they might think CPR will do more harm than good.

Your doctor should

A doctor might decide that CPR is not appropriate for someone who:

DNR forms are only used to prevent people from being given inappropriate CPR. The person will still be given all other treatments to keep them pain free and comfortable.

Cardiopulmonary resuscitation (CPR)

Cardiopulmonary resuscitation (CPR) is an emergency treatment used to attempt to restart a person’s heart and breathing.

CPR can include:

It does not cure any underlying illnesses, for example heart disease, cancer or frailty. CPR can also leave someone with serious long-term effects which they may never recover from including:

In hospital, around 2 out of 10 people survive and are well enough to leave hospital after having CPR.

The reality is even if CPR is successful at restarting the heart and breathing, it may do more harm than good.

If a doctor decides CPR is not medically appropriate, they will record this decision in your medical records, usually on a special form that healthcare professionals will recognise. They should discuss this with you.

How to question a DNR (do not resuscitate) decision

If you are not sure why a decision about DNR has been made you should ask the doctor to explain. If you still disagree with the doctor’s decision you can ask for a second opinion.

It can be upsetting to find out that a doctor has decided CPR is not medically appropriate for you or a relative. For many people this first conversation can feel unexpected, but if a doctor brings it up this probably means they think CPR will do more harm than good.

Unfortunately we know DNR decisions are not always explained. This does not necessarily mean it is the wrong decision, but the reasons for the decision have not been communicated properly.

DNR decisions must always be based on the health and priorities of each individual. There must not be blanket policies that apply DNR decisions to groups of people.

Do you need help?

If you are concerned about a DNR form that’s been made about you or a relative, you can contact us by:

How to get a DNR (do not resuscitate) form

If you want to refuse CPR, you should ask your GP or the doctor in charge of your care to record this decision in a DNR form.

You can only get a DNR form from your doctor.

What to do next

  1. Make an appointment with your GP
  2. You may need to explain your reasons for wanting to refuse CPR, so think about what you might say in advance
  3. Think about other ways you can also put your wishes down in writing, for example by making a living will (advance decision)

Decisions about CPR can be recorded in different ways. Your doctor might use a DNR form or another process like ReSPECT.

We know that some people are told by their GP they are too young and healthy to have a DNR form. If this has happened to you, contact us by:

How to make sure a DNR (do not resuscitate) form is valid

There are different versions of DNR forms in the UK. If you have questions about what address should be on the form, who needs to sign, or if an old form is still valid you can ask your GP.

If you move into a new care setting, for example to a care home, you should ask if your current form is valid.

In an emergency

In most situations CPR will be attempted unless there is a clear DNR in place.

If you have a DNR form, your doctor should share it with the wider clinical team, this may include:

If you are worried that your DNR form will not be found, you should speak to your GP.

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