Legal Definitions - OOH-DNR

OOH-DNR stands for Out-of-Hospital Do-Not-Resuscitate order.

An Out-of-Hospital Do-Not-Resuscitate (OOH-DNR) order is a legal document or instruction signed by a patient or their authorized surrogate, and typically a physician, that directs emergency medical personnel and other healthcare providers not to perform cardiopulmonary resuscitation (CPR) or other life-sustaining measures if the patient's heart or breathing stops while they are outside of a hospital setting. This order ensures that a person's wishes regarding end-of-life care are respected in environments such as their home, an assisted living facility, or during transport by ambulance, preventing interventions like chest compressions, artificial ventilation, or defibrillation.

• Example 1: Elderly Individual at Home

  An 85-year-old woman with advanced heart disease lives at home with her family. After discussing her wishes with her doctor and family, she decides she does not want to be resuscitated if her heart stops. She obtains an OOH-DNR order, which is prominently displayed in her home and also kept with her medical records. One evening, she collapses, and her family calls 911. When paramedics arrive, they see the OOH-DNR order. In accordance with the order, they provide comfort care but do not initiate CPR or other resuscitative efforts, respecting her prior decision.

• Example 2: Resident in an Assisted Living Facility

  A 70-year-old man residing in an assisted living facility has a progressive neurological condition. He has made it clear to his family and the facility staff that he wishes to die peacefully without medical intervention if his condition worsens to the point of cardiac or respiratory arrest. He has a valid OOH-DNR order on file with the facility and with local emergency medical services. If he were to stop breathing during the night, the facility staff would call 911, and upon the arrival of paramedics, the OOH-DNR order would instruct them not to attempt resuscitation, allowing him to pass away naturally as per his documented wishes.

• Example 3: Individual with Terminal Illness in Public

  A 60-year-old woman with terminal cancer is out shopping. She carries a wallet card indicating her OOH-DNR status, and her medical alert bracelet also signifies this instruction. She suddenly collapses and becomes unresponsive. Bystanders call 911. When emergency medical technicians (EMTs) arrive, they quickly identify her OOH-DNR status from her wallet card and bracelet. Despite being in a public place, the EMTs are legally bound by the OOH-DNR order and will not perform CPR or other life-saving interventions, instead focusing on ensuring her comfort and dignity.