DNR or AND: What You Need to Know

Editor's Note: This article discusses sensitive topics related to death, specifically end-of-life care, which may be distressing for some readers.

Shortly after I was diagnosed with COPD, I developed heart problems and an eventual sudden cardiac arrest. This can happen when the electrical part of your heart stops. This can occur when the electrical system of your heart ceases to function properly. It's similar to a toaster that stops working because it's not completely plugged into the socket.

The paramedics were wonderful; they got to me quickly, and I was extremely lucky. In fact, the same paramedic team would save my life two more times that year.

However, as my family told me what had happened in the five days I was in a coma, it became frighteningly clear what could have happened. Afterward, I knew that I needed to have everything in order.

Understanding DNR orders

Suddenly, do-not-resuscitate orders, commonly referred to as a DNR, started flying around the room. Doctors were concerned about how far that team took on me that night. I was concerned that my brain could have been deprived of oxygen long enough to cause brain damage or that I would end up a vegetable.  

These were sobering thoughts for me.  I thought of the logistics of what and how my family would manage or not manage in its aftermath. I was just so grateful for life that I never let those questions sink in.

What is a DNR?

DNR is a form that you sign that allows you to decide what kind of end-of-life care you want. It could include CPR, electrical cardioversion (electric shocks to the heart), transfusions, intubation, or medications that will help keep you alive.

Reconsidering DNR decisions

It was easy at the beginning to just say well, don't resuscitate but in that year, I would have two more sudden cardiac arrests, and my life was saved by the same paramedics each time. When I was in rehab, one of our afternoon education sessions was about signing a DNR.

Some interesting facts were brought up at this meeting, and it made me think that perhaps signing a DNR isn’t always the best option.

Modifying a DNR

There are options to modify a DNR, such as allowing some medical interventions such as oxygen but not being willing to be hooked up to a breathing machine.

• Instead of a DNR, we can choose to Allow Natural Death (AND). It also allows for a natural death that provides support to you and your family.
• Only you or your medical power of attorney can sign a DNR or an AND order. Have an intentional talk with your doctor, make sure he knows, and be prepared with a list of questions.
• Don’t be in a hurry to make the decision. Think about it and have another appointment with other medical professionals.
• Don’t let the opinions of others influence you. Only you can choose, and only your opinion is important.

You should complete your DNR or AND several years before you need either. Consider that the passage of time can change your request and that your DNR or AND form will need to be reviewed often.

Editor’s Note: We are extremely saddened to say that on January 7th, 2024, Barbara Moore passed away. Barbara’s advocacy efforts and writing continue to reach many. She will be deeply missed.