A Do Not Resuscitate order instructs medical personnel not to perform CPR if your heart or breathing stops. It is one of the most tightly regulated documents in end-of-life planning: unlike a living will, which you can sign on your own, a DNR that emergency responders will actually honor is in most states an official state form (often called an out-of-hospital DNR, POLST, or MOLST) signed by a physician.
That is why this document is honest about its role: it is a written declaration of your wish to decline resuscitation, prepared to take to your doctor, who can then complete and sign your state's official order. The declaration also documents your decision for your medical record, your family, and your healthcare agent.
How DNR orders actually work
By default, emergency medical personnel must attempt resuscitation: when 911 is called and someone is in cardiac arrest, EMS starts CPR unless a valid order tells them not to. What counts as a valid order is defined by each state, and the rules are strict on purpose, because responders must make the call in seconds. Most states honor only their official out-of-hospital DNR form or a POLST/MOLST signed by a physician (in some states also a nurse practitioner or physician assistant), and several require or strongly recommend a state-approved bracelet, necklace, or wallet card so the order is visible in an emergency. A homemade letter, on its own, will generally not stop EMS from starting CPR.
- In a hospital or nursing facility: a DNR is entered in your chart by the attending physician after a conversation with you or your healthcare agent; the facility's order controls there.
- Outside a facility: the state's out-of-hospital DNR or POLST form, signed by an authorized practitioner, is what EMS looks for, along with any required identifier.
- This declaration's role: documenting your informed wish, starting the conversation with your physician, and supporting the official order in your record.
DNR, living will, POLST: which does what
| Document | What it covers | Who signs it |
|---|---|---|
| DNR order | CPR only: no resuscitation if heart or breathing stops | You (or your agent) and a physician, on the state form |
| Living will | Life-sustaining treatment wishes if you are terminal or unconscious | You, usually with witnesses or a notary; no doctor needed |
| POLST / MOLST | Concrete medical orders across treatments, for the seriously ill | You and your physician or authorized practitioner |
| Medical power of attorney | Names an agent to decide for you when you cannot | You, usually with witnesses or a notary |
The documents work together. A living will states your values and treatment wishes broadly; a medical power of attorney gives someone authority to apply them; a DNR or POLST converts a specific decision, no CPR, into a medical order that responders can follow instantly. If you are seriously ill, ask your physician about POLST: it covers resuscitation plus intubation, hospitalization, and other interventions in one portable order form.
From this declaration to an enforceable order
- Complete this declaration and read it carefully; it states your wish and asks your physician to complete the official state order
- Make an appointment with your physician and bring the declaration; the conversation about your condition and prognosis is part of informed consent
- Sign the official state DNR (or POLST/MOLST) form with your physician, and obtain any bracelet, necklace, or wallet card your state uses
- Post or store the order where responders will find it (many states suggest the refrigerator door or bedside), and give copies to your family, agent, and facility
- Review it after any major change in health, and remember you can revoke it at any time, by any means
The official state form is what gets honored
Rules differ by state on the form, the required signatures, and the identifiers responders look for. This declaration is a self-help document that records your wish and is not itself a medical order; complete your state's official DNR or POLST form with a physician to make your wish enforceable in an emergency.
Frequently asked questions
Is this document a legally binding DNR order?
No, and no honest template can be. In most states, emergency responders may only honor the state's official DNR or POLST form signed by a physician or other authorized practitioner. This declaration documents your informed wish, goes in your medical record, and is designed to be taken to your doctor to complete the official order.
Why does a DNR need a doctor's signature?
Because a DNR is a medical order, not just a personal statement. The physician's signature confirms you were informed about your condition and the consequences of declining CPR, and it is what authorizes EMS and hospital staff to withhold resuscitation without a case-by-case legal judgment.
Does a DNR affect other treatment?
No. A DNR covers resuscitation only: what happens if your heart or breathing stops. It does not limit pain relief, oxygen, antibiotics, surgery, or any other care. Wishes about broader life-sustaining treatment belong in a living will or a POLST discussed with your physician.
Can I change my mind after signing a DNR?
Yes, at any time and by any means, including simply saying so. Tell your physician so the official order is voided and removed from your record, destroy printed copies and any bracelet or wallet card, and inform your family and healthcare agent.
What is the difference between a DNR and a POLST?
A DNR addresses one decision: no CPR. A POLST (called MOLST in some states) is a fuller set of portable medical orders for seriously ill patients, covering resuscitation plus intubation, hospitalization, and other interventions. Both are signed with a physician; your doctor can advise which fits your situation.