What is the legal significance of a Do-Not-Resuscitate (DNR) order?

• A. It creates a legal requirement to perform CPR in all cases.
• B. It is used to schedule follow-up care after discharge.
• C. It documents patient wishes regarding CPR; must be validly executed, updated, and included in the record; enforceable where recognized by law.
• D. It automatically overrides all other advance directives.

Answer: (C)

A Do-Not-Resuscitate order has legal significance because it records a patient’s explicit wish about whether to attempt CPR when the patient’s heart or breathing stops, and it becomes binding only if it is properly created and available to the treating clinicians. The key point is that this order is about resuscitation decisions, not about all medical care. When it is validly executed, signed, dated, updated as needed, and included in the patient’s medical record, it is enforceable in settings that recognize such orders under the law. It can be revoked or changed if the patient’s preferences change or if the patient regains decision-making capacity.

This does not mean CPR will be performed in all cases, nor does it automatically override every other advance directive or instruction unless those directives are consistent with the DNR and properly integrated (for example, some patients may have broader advance directives or POLST forms that specify limitations across life-sustaining treatments). It also does not address follow-up care scheduling, and its effect depends on the jurisdiction’s requirements and the presence of a valid, accessible order during emergencies.