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Do Not ResuscitateA DNR, or Do Not Resuscitate order, is a written order from a doctor that resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. This is sometimes known as a no-code order. Such an order may be instituted on the basis of an advance directive from a person, or from someone entitled to make decisions on their behalf, such as a health-care proxy; in some jurisdictions, such orders can also be instituted on the basis of a physician's own initiative, usually when resuscitation would not alter the ultimate outcome of a disease. This is done when a person with an inevitably fatal illness does not wish to prolong the suffering, and wishes to have a more natural death without painful or invasive medical procedures. The DNR order came into being in the U.S. in the 1960s when defibrillation allowed the reversal of cardiac arrest, but this may prolong the life of the patient for only a short time. In the U.S., cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS) should not be performed if a valid written "DNR" order is present. In any cases of doubt, emergency medical technicians, paramedics and other medical workers will perform as if a DNR order did not exist, as is required by law. For the DNR to be valid there may be rules such as the use of a special form and/or additional signatures of a doctor and/or witnesses, etc. The exact rules for obtaining and for emergency medical personnel accepting the validity of a DNR order vary widely according to jurisdiction. For example, in the state of Maryland, only Maryland-state DNR orders are acceptable, and they require much verification, witnesses and doctor's signatures in order to be valid. In contrast, the state of West Virginia allows patients to receive a DNR order with relative ease, and will accept them from most other jurisdictions. A DNR order's specific effect depends on the hospital in which the death occurs: neither cardiopulmonary resuscitation nor intubation will be performed, but treatment for infections or other treatable conditions, intravenous feeding and fluids, pain management and comfort care are generally continued. Tattoos A pensioner and former nurse in the UK has a tattoo which reads 'Do Not Resuscitate' tattooed across her chesthttp://news.bbc.co.uk/1/hi/health/2819149.stm, while an 80 year-old emergency medicine specialist in Australia has done the samehttp://www.news.com.au/story/0,10117,12291630-29280,00.html. See also External link Example of a DNR form
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