Given that the medical practice deals with sustaining human life at all costs, utmost efforts have been exerted to save every life placed in the hands of a medical practitioner. Part of such efforts is performing the necessary medical treatments whenever a patient's life is in danger. Recently, however, this power to perform necessary medical treatments has been restricted by the emergence of the so-called DNR order.

There are few issues in the field of medical practice that have stirred quite a debate among practitioners and even among the patients themselves. The DNR order is on top of this list. What is it? Who prescribes it? Can it be revoked? These are some of the questions we shall attempt to answer in this article.

What is a DNR order?
The DNR order is a legal document that has been conceived and designed to help certain groups of patients avoid prolonged suffering from a terminal illness or being subjected to medically irreversible conditions resulting from certain procedures. The DNR order is part of a list of advanced medical directives allowed by a federal law that has been passed in 1991. It is basically an order which instructs medical personnel-including doctors and nurses-to not perform certain medical procedures or resuscitative measures on the patient such as CPR, defibrillation, or advanced airway management, to name a few. Upon hospitalization, this order is usually indicated in the patient's chart. It must be honored at all times and, in case a physician is unwilling to honor the order, he or she will be required to transfer patient to another medical care provider.

Who prescribes it?
Legally able patients are the ones who prescribe the DNR for themselves. As an advanced directive, a DNR can be prepared by a patient beforehand with the help of his or her physician who will provide the form, and a lawyer who will draft the document. Once it has been prepared, an agent may be appointed to ensure that it will be carried out in accordance with the patient's wishes. To prevent misuse, the DNR must be signed by the attending physician before it can be considered legally binding.

Can it be revoked?
As with other legal documents, a DNR order can be revoked at any time as long as this is in accordance with the patient's wishes, communicated in a clear manner, and if the decision is a product of a rational mind. Should a patient decide prior to hospitalization, these changes must be signed and notarized depending on the state laws. Some states have maintained a database of individuals with standing DNR orders in order to monitor and regulate this practice. Whether a patient decides to uphold a DNR or revoke it, either way, it is important for a patient to let his or her family members know of such plans and if any changes have been made.

A DNR stems from the ethical and just notion of granting patient autonomy. As long as the decision made is an informed one and the person making the decision is considered capable of doing so, the DNR order will continue to be an option for terminally ill patients.