HEC Forum

, Volume 25, Issue 2, pp 161-171

First online:

Allow-Natural-Death (AND) Orders: Legal, Ethical, and Practical Considerations

  • Maura C. SchlairetAffiliated withValdosta State University Email author 
  • , Richard W. CohenAffiliated withEthics Department, Wellstar Health System

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Conversations with patients and families about the allow-natural-death (AND) order, along with the standard do-not-resuscitate (DNR) order during end-of-life (EOL) decision-making, may create engagement and understanding while promoting care that can be defended using enduring notions of autonomy, beneficence, and professional duty. Ethical, legal, and pragmatic issues surrounding EOL care decision-making seem to suggest discussion of AND orders as one strategy clinicians could consider at the individual practice level and at institutional levels. A discussion of AND orders, along with traditional DNR orders is presented. This is followed by argument and counter-argument focused on ethical, legal, and practical issues germane to EOL care decision-making associated with use of AND orders.


Allow-natural-death Do-not-resuscitate End-of-life care Advance directives