Understanding Do Not Attempt Resuscitation (DNACPR and DNAR)

A DNACPR or DNAR decision records that healthcare professionals should not try to restart your heart if it stops beating or you stop breathing. It helps them know what to do in an emergency. It can be a sensitive topic to talk about. But for some people living with a terminal illness, it can give a sense of comfort or control.

On this page we cover what DNACPR means, who can make the decision, and what it means for your other care.

If you do not feel ready to read this information now, you can come back to it another time.

You might hear the terms DNACPR, DNAR or DNR when talking about your future care.

DNACPR stands for do not attempt cardiopulmonary resuscitation. It’s sometimes called DNAR (do not attempt resuscitation) or DNR (do not resuscitate). But they all mean the same thing — that if your heart stops beating, the healthcare team will not try to start it again.

CPR is a treatment that aims to start your breathing and heart pumping if it has stopped. It can involve:

CPR is not right for everyone. How likely it is to work depends on lots of factors. But on average in the UK, fewer than 1 in 10 people (10%) who are given CPR outside of a hospital survive.

CPR is less likely to work if you’ve already got a serious illness or are approaching the end of life. It cannot cure an existing terminal illness. And it could cause discomfort or distress in the last weeks of life.

If you’re living with a terminal illness, or nearing the end of life, your doctor might have an opinion on whether CPR would work for you. It’s a good idea to discuss the possible benefits and risks for you personally with your doctor.

The decision to not try CPR can be made in advance by a doctor, or by you.

It’s a clinical decision. So, it’s usually made after a discussion with a healthcare professional, where they will consider your values and preferences.

Your doctor can decide in advance if they do not think CPR would work for you. They can make this decision even if you do not agree with it. But you should be told:

If you disagree with the DNACPR decision, you can ask for a second opinion. But you cannot ask for CPR, if the clinical teams are sure it will not work for you.

Do not be afraid to ask your doctor for more information if you have any questions about their decision. They should be able to explain their reasons for making that decision. And help you to understand what it means for you.

You can decide in advance if you do not want to have CPR. This is called making a DNACPR decision.

Tell your doctor or nurse that you do not want CPR if your heart stops beating. They will discuss your reasons why with you. They usually need to fill in a form to say you’d like to decline CPR in advance. And they’ll keep this in your medical records. See What is a DNACPR form? below.

You cannot make a DNACPR decision yourself if you do not have mental capacity. But your health and welfare Power of Attorney (if you have one) might be able decline on your behalf. The rules around this can be complicated. So, it’s best to check with a legal professional.

Talking about declining CPR in advance can feel uncomfortable. Some people do not want to have this conversation ahead of time. Others may feel like it gives them a sense of control.

Speak to your doctor if you’d like to discuss DNACPR decisions. They should be able to:

If you feel able to, talking to the people important to you about DNACPR could help you to feel less worried.

If you’d like to talk to someone about how you’re feeling, call the free Marie Curie Support Line on 0800 090 2309, or email support@mariecurie.org.uk.

You do not have to talk about DNACPR if you do not want to. Tell your doctor or nurse that you do not want to discuss it. You can also ask for this to be added to your medical records.

Your doctor can still make a DNACPR decision for you — even if you do not want to discuss it. They should let you know they’ve completed the form even if you’ve asked not to talk about it.

You can change your mind if you want to talk about it later.

A DNACPR form is a way of recording that CPR should not be tried if you stop breathing or your heart stops beating. It helps healthcare professionals know what to do in an emergency. This form is usually completed after a discussion with a healthcare professional.

You do not need to fill in or sign a DNACPR form. The healthcare professional will fill it in for you.

Some places use other emergency care plans to communicate decisions about CPR. They might use:

Your doctor or nurse will add the DNACPR decision to your medical records. This means that all healthcare professionals involved in your care should be able to see it.

But systems do not always link up. And information may not be easy to find quickly, especially in an emergency. This means some professionals may not know about your DNACPR straight away.

It’s important to tell healthcare professionals you interact with that you have a DNACPR, if you can. You should know you have a DNACPR form and where a physical copy is. And it’s best to let the people important to you know too.

You can also keep a printed copy of the form with you, in case of emergencies. For example, if you are at home or in a care home and need an ambulance.

No. A DNACPR is not legally binding. It’s a way to tell healthcare professionals that they should not try CPR.

In England and Wales, you can make your decision legally binding if you create an advance decision to refuse treatment or a living will.

In Scotland and Northern Ireland, you can do something similar. But it’s not legally binding. This is known as making an advance directive.

Some people worry that a DNACPR decision will impact the rest of their care. A DNACPR decision only applies to CPR. It should not mean that other treatment will stop, or that you’ll get less care. And it does not affect other palliative care treatments, like pain relief. You should still receive the care and treatment you need.

If you have a DNACPR, the healthcare team will continue to keep you as comfortable as possible towards the end of life.

If you’re worried about this, speak to your doctor or nurse. They should explain to you what a DNACPR means for you. And reassure you that you’ll get the same care.

For emotional support or practical information from our trained team, call the free Marie Curie Support Line on 0800 090 2309 or email support@mariecurie.org.uk.