Understanding DNAR Orders and Your Rights

Medically Reviewed by: Dr Jackie Gray, Public Health Expert and Retired GP
(Carents Trusted Reviewer Programme – Last reviewed July 2025)

A DNAR form is signed by a doctor and tells medical staff not to try CPR for the person named on it. Without this form, staff will always attempt CPR.

• A DNAR decision only applies to CPR.

• It does not mean stopping other treatments, medicines, or comfort care.

These forms are not legally binding orders, but staff usually follow them. They may still attempt CPR if the situation is very different from what was expected, for example, if someone chokes on food.

Around 80% of people who die in UK hospitals have a DNAR order in place.

Only a health professional can make a DNAR decision or issue a DNAR form but, ideally, this should be done in consultation with the patient or their family

A doctor can still issue one without agreement if CPR is likely to cause more harm than benefit.

Many people think CPR will restore full health. In reality, it often does not work for those with serious illnesses. For example, only about 2.2% of cancer patients whose heart stops in intensive care survive to leave hospital.

When a DNAR order is in place, it can be a huge emotional weight for family members. Some may  feel relief knowing their loved one will avoid aggressive treatment that may not help. Others may feel guilt, even if the decision was made by the doctor. It’s important to remember: the order is about medical judgment, not about giving up on someone. Asking the doctor to explain exactly what will and won’t happen can help remove uncertainty.

For older people, CPR success rates are often much lower than in younger, healthier patients. Chest compressions can cause broken ribs, and recovery may mean weeks in intensive care with little chance of returning to previous independence.

Talking about DNAR can be uncomfortable. But if it is left until an emergency, your loved one may be too unwell to have their say. Doctors encourage everyone to consider their wishes early so families are not left guessing.

In the UK, you have the right to:

• Be involved in discussions about DNAR orders if you are the patient or their legal representative.

• Ask for a second opinion if you disagree.

• Request that the reasons for the decision are recorded in your medical notes.

• Access information in plain language.

If you think a DNAR order was applied without proper discussion, you can raise it with the hospital’s Patient Advice and Liaison Service (PALS).

Conversations about DNAR may be easier if you prepare. You might ask:

• “What would CPR look like for my loved one?”

• “What is the likely outcome given their health?”

• “Would it help them recover or just prolong suffering?”

Writing these questions down before the meeting can help you stay focused during a stressful discussion. If you feel overwhelmed, ask if another family member or friend can be present.

A DNAR order is just one part of planning for end-of-life care. You can also consider:

• An Advance Decision to Refuse Treatment (ADRT).

• Lasting Power of Attorney for health decisions.

• Preferences for place of care and comfort measures.

By putting wishes in writing, you reduce the burden on loved ones and help ensure your care matches your values.

The ReSPECT process (Recommended Summary Plan for Emergency Care and Treatment) helps plan ahead for medical emergencies, so if someone is too unwell to speak for themselves, their care still reflects what matters to them. It is currently in use across many areas of England and Scotland.

Unlike a DNAR form, which focuses only on CPR, a ReSPECT form looks at the bigger picture of emergency care and treatment.

A ReSPECT plan:

• Records treatments that could be helpful.

• Notes treatments to avoid.

• Reflects the person’s priorities for their health and quality of life.

• Is created through conversations between the person, their family or legal representative, and healthcare professionals.

• Can be reviewed and updated if circumstances or preferences change.

• Guides doctors, nurses and paramedics in an emergency so care matches the person’s values.

Although it is not legally binding, a ReSPECT form is designed to be used by health and care teams to make sure decisions are based on both medical advice and personal wishes

To find out more information about ReSPECT and to see if it has been adopted in your area, head to the ReSPECT website.

Medically reviewed by Dr Jackie Gray, July 2025