Do Not Resuscitate
An Out-of-Hospital Do Not Resuscitate (DNR) order is a medical directive that instructs emergency medical services (EMS) personnel not to attempt resuscitation or perform life-saving measures, including CPR, if those are your wishes. Similar to the POLST, this document should be discussed with a physician, who also signs the form.
NOTE: If you have a POLST, you do not also need a DNR. A DNR is a subset of the broader treatment options covered by a POLST.
Out-of-Hospital Do Not Resuscitate (DNR) Orders
A DNR order is a medical document that instructs EMS personnel not to use resuscitative measures if your breathing or heart stops outside of a hospital setting.
Instead, EMS providers are directed to offer:
- Airway suction
- Oxygen administration
- Pain relief
- Comfort positioning
- Emotional support and reassurance
This ensures that care focuses on comfort, dignity, and respect for your end-of-life wishes.
What’s the Difference Between a DNR and POLST?
A DNR order is a specific medical order stating that if your heart or breathing stops, you should not be resuscitated. A POLST form is more comprehensive, outlining not only DNR wishes but also other life-sustaining treatment preferences like intubation, artificial nutrition, and comfort care measures.
Why DNR and POLST Orders Matter
Without a valid DNR and/or POLST (Physician Orders for Life-Sustaining Treatment) form, emergency responders and medical staff are required to initiate full life-saving measures—such as CPR, intubation, or defibrillation—even if those interventions go against your preferences.
Having a POLST or DNR in place:
- Prevents unwanted medical interventions
- Ensures continuity of care across settings (home, ambulance, hospital, hospice)
- Protects patient autonomy and decision-making
Legal and Ethical Guidelines in California
California law strongly supports your right to accept or refuse medical treatment, including life-sustaining interventions.
Key Legal Points:
- A California DNR must include:
- The patient’s name
- The date
- Signatures from the patient (or legal healthcare agent) and their physician
- The DNR becomes part of the patient’s official medical record
- A DNR can be revoked at any time, verbally or in writing—even during an emergency
- Advance Directives can support these choices and give legal authority to a designated decision-maker
Take Action
Having a POLST or DNR in place gives peace of mind to you and your loved ones, ensuring that your care reflects your wishes when it matters most.
To ensure your wishes are honored:
- Talk with your physician about your values and care preferences
- Complete and properly sign DNR or POLST forms
- Make copies accessible—keep one at home and with your medical records, and provide one to caregivers and your healthcare proxy
- Review and update your choices regularly or if your health changes