Do-Not-Resuscitate Orders in Suicidal Patients: Clinical, Ethical, and Legal Dilemmas

BackgroundThe authors review the literature related to patients who obtain a Do-Not-Resuscitate (DNR) order in preparation for a suicide attempt.ObjectiveThe authors review the ethical issues involved in making a decision to resuscitate or not in an attempted suicide with a DNR order.MethodThe authors address the potential legal consequences of action or inaction and clinical issues to consider before a DNR order is issued.ResultsDNR laws do not take into account the situation of the mentally ill person framing a DNR order as a preparation for suicide.ConclusionThe article recommends screening for suicidal ideation before issuing DNR orders, having clear hospital policies regarding the honoring of DNR orders if suicide is attempted, and clarification of state DNR laws regarding suicide.