Understanding the perioperative do-not-resuscitate order

The primary goal of this article is to improve end-of-life (EOL) care in the perioperative period. Clinicians should be able to understand the ethical and legal foundations for the "do-not-resuscitate" (DNR) order to help patients and their families make decisions about EOL care, understand the concept of "required reconsideration" for DNR orders prior to surgical procedures, acknowledge that DNR orders are based either on the patient's perception of their quality of life (QOL) or the physician's determination of medical futility as it relates to the patient's disease process, and appreciate the distinction between prolonging life and prolonging death in the perioperative setting.