Resources (Do Not Resuscitate order)

Do not resuscitate (No CPR or DNR) order

Your doctor will talk to you about this aspect of your care in spite of how daunting it sounds. After you determine that you are palliative, and your illness is progressing, it entails signing a form that will alert paramedics not to perform aggressive chest compressions and mechanical ventilation (a breathing machine) in the case of an emergency. The form is insurance that if 911 is called, paramedics and emergency staff will help you and relieve suffering, but not try to revive you.

If you die naturally at home sooner than expected, and

  • you do not have this order,
  • and 911 is called,

by law the paramedics will aggressively resuscitate you and take you to emergency. This means aggressive chest compressions and intubation, which means, in a frail and ill person, ribs can be broken and the chest is severely compromised. Surviving it is most unlikely if your illness is at such a stage that you are in the Palliative Program.

Signing a No CPR order avoids invasive and traumatic resuscitation efforts that typically do not succeed, and potentially denies the patient and family a peaceful and graceful death at home. This order is typically left on the fridge so that medical staff has a common place to look for it if they are called. 

If your condition deteriorates suddenly, or if going to hospital is required, call your doctor or community nurse immediately, but not 911. 

Patients and families that survive an unwanted resuscitation will attest to the extreme distress it caused, and wished they had planned differently.

This is a big step for you to contemplate, and you may not feel ready to do this right away, but it will be a decision you will need to make at some point. You may wish to think about it, and talk to your family about the possibility of such a situation. It is one of those discussions where most members including the patient, in spite of the difficulty in having the discussion, feel a great relief in having done so. That said, if you reconsider your decision, it is within your rights to cancel the order. Simply speak to your doctor about it.