What is a DNR (Do Not Resuscitate) Order?
A Do Not Resuscitate (DNR) order is a legal directive that states that no medical, life-saving actions will be taken if a patient enters cardiac or respiratory arrest, including, but not limited to cardio-pulmonary resuscitation and other forms of resuscitation maneuvers.
Permissibility of a DNR in Islam?
There is a range of opinions depending on the specific circumstances of the individual. Broadly, they fall across two categories, if resuscitation activities are deemed effective at the time they would be administered and if the person receiving the resuscitation would have a reasonable likelihood of being able to survive. The second category is cases where the resuscitation would not be effective and/or is viewed as merely a short-term effort to prolong the life of someone that is terminally ill and does not have any reasonable path to survival.
It is important to note that the above are very broad generalizations, and you would need to understand the specifics of each case in order to determine the appropriate steps. It is strongly recommended to seek the advice of local scholars and medical professionals to determine the best course of action for your specific circumstance.
Here are a few additional resources that include additional criteria and frameworks used to determine permissibility.
- “Do-Not-Resuscitate Orders: Islamic viewpoint” – Published by the International Journal of Human and Health Sciences (IJHHS), the author covers viewpoints/fatwas from:
- Presidency of the Administration of Islamic Research and Ifta
- Islamic Medical Association of North America (IMANA)
- Islamic Organization for Medical Sciences (IOMS)
- Yaqeen Institute provides further analysis of broader end-of-life-care and decision-making issues (read article)
What is DNR paperwork?
One of the most important parts of a DNR is that it must be written in advance and must be signed by the patient’s physician. This must be done in order to have time to include the appropriate paperwork in the patient’s medical file. A DNR should not be a decision made lightly and on the spot. The patient must talk to his or her physician to discuss the pros and cons of such an order. In this case, contrary to that of a living will in which the patient establishes medical care preference, there is no need to draft the document in front of an attorney.
Are there alternate names for DNR?
A Do Not Resuscitate (DNR) order is also known as a Do Not Attempt Resuscitation (DNAR) order, an Allow Natural Death (AND) order, or a No Code order. The exact name is usually determined by the state’s regulations and can vary from state to state.
Why is DNR paperwork important?
Preparing a DNR in advance is possibly one of the most important steps you can take to get your affairs in order before it’s too late and somebody else has to make decisions for you. It allows you to determine if you want CPR performed on your body, knowing the pros and cons of it. It will also give your family the peace of mind of not having to make such a decision, and it will let doctors know about your wishes in case the worst happens.
Who should have a DNR in place?
Any adult over the age of 18, and who is of sound mind, should consider getting a DNR order. This is especially true in the case of nursing home patients, who are already at the end of life stage. Of course, it’s a matter of choice, an informed decision anybody should make after talking about it thoroughly with their physician. Keep in mind that a DNR order only covers CPR in case of cardiac or respiratory arrest.
In what scenarios does a DNR get implemented?
Technically speaking, a DNR is only implemented in the case of cardiac or respiratory arrest. In other words, if your heart stops or you stop breathing, a DNR will prevent medical personnel from performing CPR to restart either your heart or lungs. Keep in mind that CPR can have negative effects on the patient, which is why some people decide to request the DNR.
Can a DNR be overridden?
No. Once your physician has included your wishes for a DNR order in your medical file, nobody can override it. In some cases, when the patient has a living will and has named somebody, who could be a family member or anybody else they trust, to make any decisions regarding lifesaving care, that person, known as a health care agent, can order a DNR for the patient.
How to get DNR paperwork created?
The best and easiest way to get the paperwork for a DNA is to talk to your physician about it, he will enter it into your medical file after you have both signed it, and that will formalize the order. In some instances, you can fill out a form you should then bring to your physician for signature. Remember, a DNR is one of the most personal decisions any person can make. It should not be guided by anyone else’s opinion or wish.
