Updated
DNR vs DNI vs Full Code: What Each Order Means
A DNR (do not resuscitate) order means no CPR if the patient's breathing or heartbeat stops. A DNI (do not intubate) order means no breathing tube or ventilator if the patient cannot breathe on their own. Full code means every resuscitation measure is attempted. A DNR covers CPR only. It does not stop pain medicine, other medicines or nutrition (MedlinePlus, Cleveland Clinic).
Rules and forms vary by state and hospital, so treat this as an orientation (sources read October 31, 2026).
Full code, DNR, DNI and AND
| Code status | What it means | Source |
|---|---|---|
| Full code | What it means: If the heart or breathing stops, all resuscitation is attempted, which can include chest compressions, intubation and defibrillation. Ohio State Wexner calls it the default code status. | Source: Ohio State Wexner |
| DNR (do not resuscitate) | What it means: No CPR if breathing or the heartbeat stops. It says nothing about other treatments like pain medicine or nutrition. | Source: MedlinePlus |
| DNI (do not intubate) | What it means: No breathing tube and no ventilator if the patient cannot breathe on their own. | Source: Cleveland Clinic |
| AND (allow natural death) | What it means: Treatments that keep the patient as comfortable as possible. | Source: Cleveland Clinic |
Sources for the table: Ohio State Wexner Medical Center, MedlinePlus and Cleveland Clinic. Ohio State describes CPR as including chest compressions, intubation and defibrillation.
A DNR is about cardiac or respiratory arrest. Before that point, a DNR patient can still receive every other treatment, including a breathing tube for respiratory failure, unless they also have a DNI. Ohio State's DNRCC-A status shows the idea: the patient is treated as full code until the heart or breathing stops (Ohio State Wexner).
What a DNR covers, and how it is made
- A medical order. A provider writes it, ideally before an emergency, after talking with the patient if possible, or the health care proxy or family (MedlinePlus).
- CPR only. CPR can include chest compressions, electric shocks to restart the heart, breathing tubes and medicines. The DNR is specific to it.
- Changeable. A patient with a DNR can change their mind and request CPR.
- Outside the hospital. Wallet cards, bracelets or other DNR documents help emergency responders know the patient's wishes at home.
- Part of a plan. A DNR may be part of a hospice care plan, which focuses on comfort.
POLST and orders outside the hospital
POLST, which the national POLST Collaborative describes as portable medical orders, is a form that turns a seriously ill patient's wishes into medical orders that tell medical teams what to do when the patient cannot speak for themselves (POLST Collaborative). It is different from an advance directive. The AMA encourages patients to record their views in advance directives and to name a surrogate decision-maker, and says advance care planning is valuable for everyone, regardless of age or health (AMA Code).
What the AMA Code says about DNR orders
- Physicians must respect a patient's decision to refuse care, even when it will result in death, and should not let their personal values get in the way (AMA Code).
- A DNAR order can be appropriate for any patient at risk of cardiac arrest, regardless of age or whether they are terminally ill.
- Without an order in the record, resuscitation should be attempted if it is medically appropriate.
- Physicians should raise resuscitation early, while the patient has decision-making capacity. See capacity vs competence.
- There is no ethical difference between withholding and withdrawing treatment (AMA Code).
Common misunderstandings
| Myth | What is true |
|---|---|
| DNR means do not treat. | What is true: A DNR covers CPR only. Other treatments, such as pain medicine, other medicines and nutrition, are separate decisions. |
| DNR is only for the dying. | What is true: The AMA Code says a DNAR order can be appropriate for any patient at risk of cardiac arrest, whatever their age or diagnosis. |
| Family can cancel a patient's DNR. | What is true: MedlinePlus says that if a DNR was written at the patient's request, the family may not override it. |
| A DNR is permanent. | What is true: A patient can change their mind and ask for CPR at any time. |
End-of-life questions show up in MMI ethics stations and panel interviews as family disagreements, refusals and requests for “everything.” The SPIKES protocol helps with the conversation itself, and medical aid in dying covers the related legal question.
Practice question: a daughter wants everything done
What this station is really testing
Whether you know a DNR is about CPR only, whether you put the capable patient's wishes first, and whether you can do that without dismissing a frightened family member.
“An 88-year-old patient with advanced heart failure has a DNR order. Her daughter arrives and insists that if anything happens, the team must do everything. What do you do?”
An end-of-life station that tests whether you respect a capable patient's decision while taking a distressed family member seriously.
Example answer written by Confetto (the applicant is invented)
First I would want to understand the situation: whether the patient made this decision herself while she had capacity, and whether she still has capacity now. If she does, the best person to talk to is her.
I would sit down with the daughter, because her reaction is coming from fear of losing her mother. I would listen first, then explain gently what a DNR does and does not mean. It is only about CPR. Her mother will still get every other treatment that helps her and everything we can do to keep her comfortable.
If her mother has capacity, I would suggest the three of us talk together, with her mother's permission, so the daughter can hear her wishes directly. A DNR written at the patient's request is her decision, and the family cannot override it, but she might want to talk it through again, and she can always change her mind.
If the disagreement continued, I would involve the attending physician and, if needed, palliative care or the ethics team. My aim would be that the patient's wishes are followed and the daughter does not feel shut out.
Sources: MedlinePlus, Cleveland Clinic, Ohio State Wexner Medical Center, the POLST Collaborative and the AMA Code of Medical Ethics, checked October 31, 2026.
Frequently asked questions
What is the difference between DNR and DNI?
A DNR means no CPR if the heart or breathing stops. A DNI means no breathing tube or ventilator if the patient cannot breathe on their own. A patient can have one, both or neither. See Cleveland Clinic on DNR orders.
What does full code mean?
That if the heart stops beating or breathing stops, all resuscitation procedures will be provided, which can include chest compressions, intubation and defibrillation. Ohio State Wexner calls it the default code status. See Ohio State Wexner on code status.
Does a DNR mean no treatment?
No. MedlinePlus says a DNR is specific to CPR and has no instructions about other treatments such as pain medicine, other medicines or nutrition. See MedlinePlus on DNR orders.
What is a POLST form?
A form that turns a seriously ill patient's wishes into medical orders that tell medical teams what to do when the patient cannot speak for themselves. See the POLST Collaborative.
Can a family override a DNR?
Not one the patient asked for. MedlinePlus says that if a provider has already written a DNR at the patient's request, the family may not override it.