When Seconds Matter: What happens when a Medical Provider can’t Verify a DNR?
- codeofcures
- Oct 3
- 4 min read
Should they resuscitate by default? Will they get sued?
By Crystal Kong and Chloe Cherng, High School Students
A Do Not Resuscitate order, more commonly known as a DNR, is a legal document instructing medical staff not to perform cardiopulmonary resuscitation (CPR) if a patient’s breathing or heart stops. It’s important to note that a DNR is not about withholding other treatments; it specifically addresses CPR and advanced cardiac life support. In New York, DNR orders can be issued for patients in hospitals, nursing homes, or even at home. In order for it to be valid, there must be:
Informed Consent – The patient or their legal healthcare proxy must provide informed consent for the order after receiving a clear explanation of the implications of DNR status.
Proper Documentation – The order must be clearly documented in the patient’s medical chart, including any supporting directives, such as living wills or advance healthcare directives.
Accessibility – The DNR order must be readily accessible to medical personnel, especially in emergency settings. (Liberatore, Med Legal Pro)
Failing to Identify a DNR
During life or death situations, when a patient needs resuscitation, such as on the accident site, resources to identify a DNR become limited. A patient may have a tattoo or bracelet indicating they have a DNR, but without any legal documentation, healthcare providers cannot assume the validity of such a designation. In this case, healthcare professionals are legally and ethically obligated to perform resuscitation since withholding life-saving measures without verified orders could be considered medical negligence. However, if a DNR becomes known during resuscitation, they must honor it by ceasing resuscitation and providing comfort-focused care that avoids invasive interventions, like CPR.
When this happens, the patient or family may feel their wishes were violated and pursue legal action. However, a provider acting this way is usually protected legally as they were following the standards of care and acted in good faith based on the information available at the time. They cannot be punished for not honoring a DNR they were not aware of. As a result, lawsuits in these cases are rarely successful, since the providers are viewed as acting responsibly and within the scope of their professional obligations: to preserve life unless instructed otherwise by proper documentation.
Ignoring a Known DNR
When a healthcare provider intentionally ignores a DNR, they are subject to legal consequences, and it may be considered medical malpractice. It can be seen as:
Medical Negligence: The provider owed a duty to the patient and breached their duty, causing harm.
Violation of Patient Rights: Can violate laws governing patient autonomy.
Civil Liability: Prolonged suffering or physical harm caused by unwanted resuscitation.
Thus, it is important for healthcare providers to honor a DNR even if it may undermine the ethical principle of beneficence.
DNR Ethics
When it comes to DNR during emergency situations, medical providers must balance their duty to preserve life with their duty to respect patient autonomy. When it comes to providing care, healthcare professionals must always honor the ethics behind the field, but the importance of them becomes extremely relevant when it comes to DNR.
Medical providers must always respect patient autonomy, whether they have a DNR or not. If they ignore a DNR, it undermines the patient's wishes; however, performing resuscitation when no DNR is known is also considered protecting autonomy by not assuming refusal without proof. It is also to be known that patients can revoke a DNR at any time, and this decision must also be respected.
The ethical principle of beneficence can conflict with autonomy. In terms of patient care, doctors are always required to act in the best interest and well-being of the patient, but when a DNR exists, they may not be able to. Even when CPR may provide a medical benefit to the patient, doctors must respect patient autonomy. In relation to beneficence, doctors must also honor non-maleficence, which is to do no harm. In accordance with doing no harm, a DNR helps avoid unnecessary harm because sometimes performing CPR is not medically beneficial to the patient, as it may cause broken ribs, extreme suffering, and diminish quality of life–especially for terminally ill patients. CPR is not always successful, especially in severe or terminal illness, and thus patients choose a DNR. In these cases, not performing CPR helps reduce suffering and preserves dignity during end-of-life care.
Conclusion
When it comes to emergency care, the inability to verify a DNR means providers must make decisions swiftly. When resuscitating by default, providers are protected legally, but the true ethical dilemma lies in honoring patient autonomy and dignity even under uncertainty.
Works Cited
Falasco, G. (2025, May 29). Ignored DNR or Molst orders ? here are your legal options. Salenger, Sack, Kimmel & Bavaro, LLP. https://sskblaw.com/what-happens-if-a-dnr-or-molst-is-ignored-in-ny
Liberatore, T. (2025, August 11). The overlooked do not resuscitate (DNR) order: Legal complexities and the role of medical experts in medical malpractice cases. Med Legal Pro. https://medlegalpro.com/the-overlooked-do-not-resuscitate-dnr-order-legal-complexities-and-the-role-of-medical-experts-in-medical-malpractice-cases/
Professional, C. C. medical. (2025, April 7). DNR: What it means & how it works. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/8866-do-not-resuscitate-orders
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