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Jack E. Zimmerman, MD; William A. Knaus, MD; Elizabeth A. Draper, RN, MS
The George Washington University Medical Center Washington, DC

JAMA. 1986;255(22):3114-3115.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

We agree with Drs Elliott and Day and Dr La Puma that DNR orders mean that only cardiopulmonary resuscitation should be withheld. The hospitals in our study all based their practices on this definition. Like many forms of treatment, cardiopulmonary resuscitation might be accepted or rejected by a patient or surrogate, depending on its appropriateness.¹ It would be improper to use DNR orders to sanction death, withdraw therapy, or fail to relieve pain or provide comfort, and nothing in our study indicated that this occurred.

Nevertheless, while guidelines and policies for writing DNR orders are widely available, physicians have received little guidance about how to indicate and proceed with other treatment limitations.^2,3 Acronyms indicating such limits (DNI [do not intubate], SCO [supportive care only], or DNT [do not treat]) are not widely recognized, well characterized, or used. As indicated in our article, however, DNR decisions "were . . . [Full Text PDF of this Article]

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