Orders Not to Resuscitate: The Origin of the DNR Order
Learning Objectives
Recall the historical context that led to the development of Do‑Not‑Resuscitate (DNR) policies in modern medicine
Explain how early adoption of closed‑chest CPR created clinical and ethical challenges around indiscriminate resuscitation
Analyze the ethical reasoning behind limiting resuscitative and airway interventions at the end of life
Apply principles from early DNR frameworks to modern airway escalation decisions, including intubation and ECMO
Evaluate how transparency, communication, and shared understanding evolved in resuscitation decision‑making
Author(s)
Mitchell T. Rabkin MD
Distinhuised Institute Scholar | Shapiro Institute
Professor of Medicine | Harvard Medical School
President/CEO | Beth Israel Hospital
CEO | CareGroup
Dennis Daniel, MD
Associate Program Director, Critical Care Medicine Fellowship
Associate, Critical Care Medicine
ECMO Medical Director, Medical-Surgical Intensive Care Unit (MSICU) | Boston Children's Hospital
Instructor of Anaesthesia | Harvard Medical School
Jefferey Burns, MD, MPH
Assoc. Chief Medical Officer, Critical Care Services; Shapiro Chair in Critical Care Medicine, Division of Critical Care MedicineDirector, OPENPediatrics; Sr. Assoc. in Critical Care Medicine; Department of Anesthesiology, Critical Care & Pain Medicine | Boston Children's Hospital
Professor of Anesthesia | Harvard Medical School
Citation
Rabkin M, Daniel D, Burns JP. Orders Not to Resuscitate: The Origin of the DNR Order. 1/2017. Online Video. OPENPediatrics. https://learn.openpediatrics.org/learn/course/internal/view/elearning/3233/orders-not-to-resuscitate-the-origin-of-the-dnr-order.