Does the New York State DNR Law Prevent Medically Inappropriate DNR?

  • Judith C. Ahronheim
  • Sathya Maheswaran
  • Carl Rosenberg
Part of the Philosophy and Medicine book series (PHME, volume 48)


The designers of New York State’s Do-Not-Resuscitate (DNR) law endeavored, among other things, to create a means of preventing medically inappropriate resuscitation — that is, resuscitation that “will probably fail or succeed only to the extent that the patient is repeatedly resuscitated in a short time period before death” ([10], pp. 6–8). The word “fail” is not further defined, but the law permits the physician to make the decision to withhold CPR in cases of “medical futility,” which is defined as a situation in which CPR would be “unsuccessful in restoring cardiac and respiratory function” or that the patient would “experience repeated arrest in a short time period before death occurs” ([8], §2970). To this end, the law would provide immunity to doctors who wrote DNR orders in good faith, and means would be devised to overrule families who insisted on resuscitation that would clearly be medically futile. Although it is doubtful that regulations mandated and delineated by state law have any advantages over existing practices [6], another, and possibly primary purpose of the law was to prevent covert DNR orders. To this end, the law would require a process whereby consent not to resuscitate would have to be obtained from the patient or surrogate in all but a few, highly exceptional circumstances.


Hepatic Encephalopathy Cardiopulmonary Resuscitation Medical Futility General Medical Patient Chronic Medical Disease 
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  1. 1.
    Ahronheim, J.C., Maheswaran, S. and Rosenberg, C.: 1992, ‘Impact of Do-Not-Resuscitate Legislation on the Use of Cardiopulmonary Resuscitation in Three Teaching Hospitals’, New York State Journal of Medicine 92, 281–185.Google Scholar
  2. 2.
    Applebaum, G.E., King, J.E. and Finucane, T.E.: 1990, ‘The Outcome of CPR Initiated in Nursing Homes’, Journal of the American Geriatric Society 38, 197–200.Google Scholar
  3. 3.
    Bedell, S.E. et al.: 1983, ‘Survival After Cardiopulmonary Resuscitation in the Hospital’, New England Journal of Medicine 309, 569–576.CrossRefGoogle Scholar
  4. 4.
    Hershey, C. and Fisher, L.: 1982, ‘Why Outcome of Cardiopulmonary Resuscitation in General Wards is Poor’, The Lancet 1, 31–34.CrossRefGoogle Scholar
  5. 5.
    In re Westchester County Medical Center (O’Connor), 72 N.Y. 2d 517, 534 (1988). N.Y.S. 2d 886, 531 N.E. 2d 607 (1988).Google Scholar
  6. 6.
    McClung, J.A. and Kamer, R.S.: 1990, ‘Legislating Ethics. Implications of New York’s Do-Not-Resuscitate Law’, New England Journal of Medicine 323, 270–272.CrossRefGoogle Scholar
  7. 7.
    Medical Society of the State of New York, New York State Department of Health and Hospital Association of New York State: 1990, Do Not Resuscitate Orders. Questions and Answers for Health Care Professionals.Google Scholar
  8. 8.
    New York Public Health Law Article 29-B, ch. 818. ‘Orders Not To Resuscitate’.Google Scholar
  9. 9.
    New York State Codes, Roles and Regulations.Google Scholar
  10. 10.
    New York State Task Force on Life and the Law: 1988, Do Not Resuscitate Orders. The Proposed Legislation and Report of the New York State Task Force on Life and the Law, 2nd edition, Albany, New York.Google Scholar
  11. 11.
    New York Times, October 14, 1990: A-1, B-20.Google Scholar
  12. 12.
    Swidler, R.N.: 1989, ‘The Presumption of Consent in New York State’s Do-Not-Resuscitate Law’, New York State Journal of Medicine 89, 69–71.Google Scholar
  13. 13.
    Taffet, G.E., Teasdale, T.A. and Luchi, R.J.: 1988, ‘In Hospital Cardiopulmonary Resuscitation’, Journal of the American Medical Association 260, 2069–2072.CrossRefGoogle Scholar
  14. 14.
    Timerman, A., Piegas, L.S. and Sousa, J.E.: 1989, ‘Results of Cardiopulmonary Resuscitation in a Cardiology Hospital’, Resuscitation 18, 75–84.CrossRefGoogle Scholar
  15. 15.
    Tresch, D.D. et al.: 1984, ‘Long-Term Survival After Prehospital Sudden Cardiac Death’, American Heart Journal 108, 1–5.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1995

Authors and Affiliations

  • Judith C. Ahronheim
  • Sathya Maheswaran
  • Carl Rosenberg

There are no affiliations available

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