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DNR / DNACPR

Also known as: Do Not Resuscitate, Do Not Attempt Cardiopulmonary Resuscitation

Definition

DNACPR (do not attempt cardiopulmonary resuscitation) is a medical form completed by a doctor stating that CPR should not be attempted if your heart or breathing stops.

Understanding DNACPR helps you make informed decisions about end-of-life care and ensures your Health and Welfare LPA or Advance Decision accurately reflects your medical wishes.

What Does DNR / DNACPR Mean?

DNACPR stands for "do not attempt cardiopulmonary resuscitation" and is sometimes called DNAR (do not attempt resuscitation) or DNR (do not resuscitate)—all these terms mean the same thing. The decision means that if your heart stops beating or you stop breathing, healthcare professionals will not attempt CPR to restart them. Critically, DNACPR only relates to CPR—it does not affect any other medical treatment or care you receive. The form is completed by a doctor, ideally after consultation with you or your family. Under the Mental Capacity Act 2005, if you lack capacity to decide about CPR, the decision must be made in your best interests.

Only a doctor can issue a DNACPR form. If you have capacity, your doctor should discuss the decision with you and involve you in the process. You can request a DNACPR if you don't want CPR attempted, though the doctor makes the final clinical decision. If you lack capacity, the doctor must consult your family or appointed attorney before completing the form. CPR involves chest compressions and rescue breathing to restart the heart, but success rates are low—fewer than one in ten people survive out-of-hospital cardiac arrest in England according to recent data. For elderly or seriously ill patients, success rates are even lower and CPR can cause significant injuries including broken ribs. Doctors recommend DNACPR when CPR is unlikely to succeed or would cause more harm than benefit.

DNACPR relates closely to other end-of-life planning documents. If you create an Advance Decision to Refuse Treatment specifically refusing CPR, this is legally binding and the doctor must respect your wishes. A DNACPR form would then document your advance refusal for healthcare teams. If you appoint an attorney through a Health and Welfare LPA and give them authority over life-sustaining treatment, they can make decisions about CPR on your behalf if you lack capacity. However, families without this legal authority cannot make DNACPR decisions—they can only be consulted as part of the best interests process. It's unlawful to make blanket DNACPR decisions based solely on age, disability, or living in a care home. Each decision must be individualised after clinical assessment.

Common Questions

"Can I make a DNACPR decision myself?"

Only a doctor can issue a DNACPR form, but you can request one or refuse CPR through a legally binding Advance Decision. If you have capacity, you can discuss your wishes with your doctor, who should involve you in the decision-making process. Your views should carry significant weight in the final decision.

"Does DNACPR mean I'll receive no medical care?"

No. DNACPR only relates to cardiopulmonary resuscitation (CPR). You will continue to receive all other appropriate care, treatment, medications, and support you need. It does not affect any other medical interventions or end-of-life care. Antibiotics, fluids, oxygen, pain relief, and all other treatments continue as normal.

"Can my family make a DNACPR decision for me?"

No, families cannot make DNACPR decisions. Only a doctor can issue a DNACPR form. However, if you lack capacity and have appointed an attorney with authority over life-sustaining treatment through a Health and Welfare LPA, they can make decisions about CPR in your best interests. Without an LPA, doctors must consult family but retain decision-making authority.

Common Misconceptions

Myth: DNACPR means doctors will withhold all treatment and let me die.

Reality: DNACPR only applies to CPR if your heart or breathing stops. You continue to receive all other appropriate medical care, medications, pain relief, and support. It does not affect treatments like antibiotics, fluids, oxygen, or any other intervention except CPR. The term "do not resuscitate" can sound frightening, but it refers specifically to cardiopulmonary resuscitation only.

Myth: My family can put a DNACPR on my medical records if they think it's best for me.

Reality: Families cannot make DNACPR decisions. Only a doctor can complete a DNACPR form. If you lack mental capacity and have appointed an attorney through a Health and Welfare LPA with authority over life-sustaining treatment, that attorney can make CPR decisions. Otherwise, the doctor decides based on your best interests after consulting family, but family agreement is not required.

  • Lasting Power of Attorney for Health: An LPA for Health and Welfare allows your attorney to make medical decisions if you lack capacity, including CPR decisions if you gave them life-sustaining treatment authority.
  • Advance Decision: A legally binding document where you refuse specific treatments in advance, including CPR—this achieves similar outcomes to DNACPR but you control the decision.
  • Mental Capacity Act: The 2005 Act is the legal framework governing DNACPR decisions for people lacking capacity, setting out best interests decision-making and safeguards.
  • End-of-Life Wishes: DNACPR is one component of expressing end-of-life wishes, specifically addressing CPR within broader care planning including treatment preferences and priorities.
  • Healthcare Decisions: DNACPR is a specific healthcare decision about CPR, part of broader medical decision-making you can address through discussions, Advance Decisions, or LPAs.

Need Help with Your Will?

Understanding DNACPR is important when creating a will because it connects to appointing Health and Welfare attorneys who may need to make CPR decisions on your behalf if you lose capacity.

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Legal Disclaimer:

This article provides general information only and does not constitute legal or financial advice. WUHLD is not a law firm and does not provide legal advice. Laws and guidance change and their application depends on your circumstances. For advice about your situation, consult a qualified solicitor or regulated professional. Unless stated otherwise, information relates to England and Wales.