Do Not Resuscitate Orders (DNR) help prevent unnecessary or unwanted treatment at the end of an individual’s life.
These orders are sometimes considered in the case of certain medical conditions such as terminal cancer, end-stage renal disease, or severe pneumonia.
Sometimes life saving intervention is not always considered to be the best option when patients stop breathing or when their heart stops beating.
Having a DNR order can inform medical professionals to not perform cardiopulmonary resuscitation (CPR) on a patient if it is against the patient’s wishes or not in their best interest.
Any competent adult can request a DNR order. In South Africa you need to set up a DNR in the form of a living will. To set up this document we advise that you speak to your legal representative.
The decision not to institute CPR should never be taken lightly, or in isolation. If the patient is competent, he or she should be involved in the decision making, as should the family members (with the patient’s consent). The best option is to have the whole healthcare team consulted.
It is extremely important to remember that these kinds of decisions should never be made on the basis of assumptions about the patient’s age, condition or perceived quality of life, but rather on a clinical assessment of the potential benefits and burdens of resuscitation on the patient. The individuals views, beliefs and wishes and those of his or her close relatives should also be taken into account as part of the decision making process.
In South Africa this DNR needs to be physically present in the form of a document when the patient is unable to communicate or dying to prevent CPR from being initiated. Without the physical presence of this document at the patient side, the DNR order cannot be enforced and medical personal will have to perform all life saving protocols that are warranted at the time.
IT IS IMPERATIVE THAT YOU INFORM YOUR FAMILY AND MEDICAL PREVENTATIVES ABOUT YOUR LIVING WILL AND WHERE YOU KEEP IT.
It is essential that you make sure your family understand your wishes, and that they will be responsible for finding your Living Will and handing it to those treating you.
If your family is far away you should give a copy of your signed Living Will to a close friend.
It is also advised to create a back-up document as the Living Will will have to accompany the patient when taken into medical care to ensure that their wishes are fulfilled.