When doctors discuss future medical arrangements with patients or their families, they may mention “Do Not Attempt Cardiopulmonary Resuscitation” (DNACPR). For many people, hearing “Do Not Attempt Cardiopulmonary Resuscitation” for the first time may raise a number of questions:
“Does this mean the doctor will no longer try to save the patient?”
“If there is a DNACPR order, does it mean the patient will no longer receive other treatments?”
“What is the difference between DNACPR and an Advance Medical Directive (AMD)?”
In fact, “Do Not Attempt Cardiopulmonary Resuscitation” does not mean giving up all treatment or care. It is a medical arrangement specifically concerning cardiopulmonary resuscitation (CPR).
Below, we explain what CPR and DNACPR mean, and how they are related to an Advance Medical Directive (AMD).
What Is Cardiopulmonary Resuscitation (CPR)?
Cardiopulmonary resuscitation (CPR) is an emergency life-sustaining treatment, mainly performed when a person experiences cardiac arrest. Its purpose is to try to restore or maintain blood circulation and the supply of oxygen to vital organs.
CPR may include chest compressions, assisted ventilation and defibrillation. CPR can save lives in some circumstances. However, for people with serious and irreversible illnesses who are approaching the end of life, CPR may not achieve the intended outcome.
Therefore, when discussing future medical arrangements, doctors may discuss with patients and their families whether CPR should be attempted if the person experiences cardiac arrest in the future.
What Does “Do Not Attempt Cardiopulmonary Resuscitation” Mean?
“Do Not Attempt Cardiopulmonary Resuscitation” generally refers to a Do-Not-Attempt Cardiopulmonary Resuscitation order (DNACPR).
Simply put, a DNACPR is a medical order specifically concerning CPR. If the patient experiences cardiac arrest, CPR will not be performed.
A DNACPR mainly answers one specific question:
“If the patient’s heart stops beating, should CPR be attempted?”
If the relevant order is valid and applicable, the answer is no. However, this does not mean that the patient will no longer receive other medical treatment or care.
Does Having a DNACPR Mean “Doing Nothing”?
No.
“Do Not Attempt Cardiopulmonary Resuscitation” only applies to CPR. It does not mean that all treatment will be stopped.
Even when a DNACPR applies, the patient can continue to receive other appropriate medical care, such as basic care, symptom management, palliative care, and psychological, social and spiritual support according to the needs of the patient and family.
Therefore, “not attempting CPR” and “not receiving further treatment” are two different things.
A DNACPR does not mean “doing nothing”. Instead, it provides a clear arrangement regarding whether CPR should be attempted under specific circumstances.
How Is DNACPR Related to an Advance Medical Directive (AMD)?
DNACPR and an Advance Medical Directive (AMD) are both related to decisions about life-sustaining treatment, but they are not exactly the same.
An AMD allows a person to express their wishes in advance regarding certain life-sustaining treatments, while a DNACPR is a medical order issued by a registered medical practitioner specifically concerning CPR.
An Advance Medical Directive allows an adult, while they still have mental capacity, to express their wishes regarding future life-sustaining treatment. If the person later loses the relevant decision-making capacity and the specified circumstances stated in the AMD apply, healthcare professionals will follow the valid and applicable AMD when making decisions about the relevant life-sustaining treatment.
An AMD may cover different types of life-sustaining treatment, and CPR is one of them. Therefore, an AMD is not the same as a DNACPR, although an AMD may include a person’s wish to refuse CPR.
Learn more about AMD:
Advance Medical Directive (AMD): A Complete Guide
Can Family Members Decide That CPR Should Not Be Attempted?
It cannot simply be understood that “if the family decides not to resuscitate, they can ask the doctor not to perform CPR”.
An AMD is made by the person themselves while they still have mental capacity, allowing them to express their wishes regarding future life-sustaining treatment. A DNACPR involves a medical arrangement made by a doctor based on the patient’s clinical circumstances.
However, family members can still participate in Advance Care Planning (ACP) discussions. This can help the healthcare team understand the person’s values, treatment preferences and future care arrangements.
Discussing these issues early can help family members better understand and support the person’s wishes if the person is no longer able to communicate or make decisions in the future.
“Do Not Attempt CPR” Does Not Mean “Giving Up Treatment”
When people first hear “Do Not Attempt Cardiopulmonary Resuscitation”, they may easily interpret it as meaning that “the doctor has decided not to save the patient”. In fact, a DNACPR is a specific medical arrangement concerning CPR. It does not mean stopping all treatment, nursing care or palliative care.
Similarly, an Advance Medical Directive does not mean giving up treatment. The core value of an AMD is to allow a person, while they still have mental capacity, to express their wishes regarding future medical decisions in advance, so that their healthcare choices can be respected under specific circumstances.
If you or your family are considering an Advance Medical Directive, Advance Care Planning, home palliative care or end-of-life care at home, YDCare provides professional nursing and multidisciplinary team support to help patients and families understand different care options and provide support throughout different stages of care.
Read More:
Will Doctors Stop Treating You After Signing an Advance Medical Directive? 5 Common Misunderstandings About AMD
Planning for End-of-Life Care at Home: What Families Should Know
