An appropriate knowledge of the person's medical condition and decision-making capacity is necessary when considering a DNR order. The responsible physician will determine the appropriateness of initiating the DNR order process for a person. The decision to implement a DNR order varies depending on the person's status. Unless medically contraindicated, the person should be informed of the initiation of a DNR order. When the person is capable of making a decision, the DNR decision will be reached consensually by the person and physician.
Parental approval is needed for a DNR order to be initiated for a minor.
The responsible physician should talk to the parents of the child and provide support to the family and child in arriving at the decision. DNR orders may be compatible with maximum therapy. The person may be receiving vigorous support in all other therapeutic modalities and yet justifiably be considered a proper subject for a DNR order. The decision not to resuscitate a person should be written in the progress notes by the responsible physician. The note should reference the discussion with the person or responsible party and the medical judgment which makes the DNR decision appropriate.