DNR forms and CPR decisions

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

They are a helpful way to protect people from being given CPR (cardiopulmonary resuscitation) inappropriately.

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

Information:

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

How 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

  • explain why they want to discuss CPR with you (or a relative if you cannot communicate)
  • ask what your priorities are, and what outcomes you want to avoid
  • explain if they think CPR is medically appropriate or not

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

  • is older and frail
  • has a serious illness and is near the end of life
  • does not want their life artificially prolonged

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.

CPR

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

CPR can include:

  • chest compressions (pressing down hard on the chest repeatedly)
  • electrical shocks to stimulate the heart (sometimes more than once)
  • injections of medicine
  • artificial ventilation of the lungs

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:

  • brain damage
  • broken ribs
  • loss of independence
  • needing long-term care

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 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 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.

Information:

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. Consider 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:

Related content

There are different things you can do in advance to tell people what treatment and care you will want in the future.

  • Living will (advance decision) – a legally binding form used to refuse any medical treatments that you do not want to be given in the future
  • Advance statement – used to say what care you do want, for example where you want to live and be cared for
  • Lasting Power of Attorney – give someone you trust the legal right to make decisions for you if you cannot make decisions for yourself

How to make sure a DNR 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:

  • out of hours team
  • local hospital
  • local ambulance trust
  • GP surgery

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

Page last reviewed: 14 January 2022
Next review due: 14 June 2022