DNR discussions with clinicians: neutral language to start conversations

Some topics make my palms sweat before I even step into the clinic. Talking about a “Do Not Resuscitate” order—what it means, when it makes sense, how to document it—used to be one of those for me. I kept worrying I would say the wrong word and close a door I needed to open. Over time, I realized the conversation doesn’t have to be dramatic or final; it can be calm, precise, and centered on what matters to me. Today I’m writing down the neutral, plain-English phrases that helped me start these talks with clinicians without feeling like I was making a courtroom speech.

I’m sharing these lines the way I’d jot them in a personal journal—no scripts, no guarantees—just the wording that made the first minute of the conversation easier. I also included a few evidence-informed notes so you can reality-test the language with reputable sources and adapt it to your situation and state rules.

When I finally found words that didn’t feel loaded

I had to unlearn a few phrases. Saying “I don’t want anything done” was too vague and sometimes misleading, because it sounded like I was declining all care, when what I meant was “no chest compressions, no shocks, no breathing tube if my heart or breathing stops.” So I practiced framing the topic as a decision about a specific emergency procedure (CPR) and its likely outcomes for someone like me, not an all-or-nothing stance on care. One high-value shift was naming what matters first—comfort, time at home, mental clarity—then asking how CPR aligns with those goals. For background on what CPR involves and how outcomes vary by age and illness, I found patient-friendly explanations from national organizations helpful to skim during a quiet moment at home.

  • Try this opener: “I’d like to talk about what would happen if my heart or breathing stopped. Could we review how CPR might help someone in my condition?”
  • Why it works: It keeps the focus on outcomes and fit, not on being “for” or “against” anything in general.
  • Reality check: Survival after CPR depends on many factors. I sanity-check my understanding with neutral, educational pages from MedlinePlus and the National Institute on Aging before appointments.

How I open the door in a short visit

Clinic visits are fast. I learned to get to the point, invite guidance, and ask for documentation steps so the decision doesn’t live only in a conversation. Here are a few neutral, time-respecting prompts that have worked for me:

  • “Could we set aside five minutes to talk about resuscitation options and what’s realistic for me?”
  • “I’m not looking for a final decision today. I just want to understand the likely benefits and burdens of CPR in my case.”
  • “If I decide on a DNR order, how would that be written in my chart and honored in the hospital, at home, or in a nursing facility?”
  • “What would change about my care if I choose DNR, and what would stay the same?”

Those questions consistently moved the conversation from vague fears to a concrete plan. If the visit is truly packed, I ask to place a note for a follow-up dedicated to goals-of-care and documentation. When I needed a more structured way to prepare, I looked at plain-language planning tools such as the AHRQ SHARE resources and community conversation guides (useful for thinking through values before talking to a clinician): AHRQ SHARE, The Conversation Project.

Phrases that focus on outcomes not permissions

I used to stumble over “Do you allow…” or “Will you let me…”—it felt like I was asking permission for my own preferences. Now I try wording that makes it a shared, clinical decision informed by my goals and the medical facts. These phrases helped me keep neutrality and clarity:

  • “Given my health and priorities, what outcomes should I expect from CPR?”
  • “Can we look at the odds of returning to the life I value versus the risks of injury or prolonged ICU care?”
  • “If I prefer comfort and avoiding the ICU, would DNR align with that goal?”
  • “If I choose DNR, what proactive treatments remain on the table—like antibiotics, oxygen, or pain and breathlessness support?”
  • “Could we also talk about DNI (do-not-intubate) and how it relates to DNR?”

I found it grounding to know that ethical guidance encourages clinicians to discuss resuscitation status in the context of the overall plan of care, and to document clearly—another reason I bring up logistics early. Professional societies outline that DNR concerns a specific set of interventions (CPR, shocks, intubation if needed for resuscitation), not a withdrawal of all treatment. For the ethical framing clinicians are taught, I skimmed the American Medical Association’s medical-ethics section on resuscitation decisions and documentation.

Questions that make the paperwork real

Nothing felt “real” until I understood how decisions jump from the note into the orders that actually guide care across settings. These are the nuts-and-bolts questions I now keep on my phone:

  • “Where in my chart will the code status live, and how do teams see it during an emergency?”
  • “If I’m discharged, what form ensures my preferences follow me—an out-of-hospital DNR or a POLST form?” (Many states use a POLST—Physician/Provider Orders for Life-Sustaining Treatment—so EMS and facilities can honor choices. Find the program for your state via National POLST.)
  • “Who needs to sign, and how often should we revisit this?”
  • “If I change my mind, how do we update or void the order?”

Because rules vary across states, I bookmark a state-by-state explainer so I don’t assume what works in one place automatically applies everywhere. A nonpartisan legal overview (for example, from the National Conference of State Legislatures) helped me orient to state differences before I traveled or changed residences.

Making space for feelings without losing the thread

Emotions belong in this conversation. I’ve had moments when the mention of CPR brought tears, or I worried about being a “good patient.” What helps me is a simple structure I learned from communication guides: Ask–Tell–Ask. I ask what the clinician understands about my situation and goals, they tell me a balanced summary of facts in small bites, and then I ask follow-up questions to confirm we share the same picture. If either of us needs a pause, we name it and come back to the plan. This keeps us connected without drifting into ambiguity.

  • “Can you share, in plain language, what CPR might look like for me and what the likely recovery would be?”
  • “I’m feeling a little overwhelmed—could we recap the key points and next steps?”
  • “Before we decide, could you tell me what you’re weighing clinically?”

For me, neutral language isn’t cold; it’s a way to move through a tender topic without getting stuck. I remind myself that choosing DNR does not mean “no care”—it often means focusing care on comfort, symptom relief, and treatments that align with my values.

A pocket framework I can remember in the clinic

When my mind blanks, I use this three-part framework. It’s boring, which is probably why it works under stress:

  • Step 1 — Notice: Name what matters to you right now (comfort, independence, staying out of ICU, time with family). Write down two sentences you can read aloud.
  • Step 2 — Compare: Ask how CPR and intubation affect those goals given your current condition. Use words like “benefits,” “burdens,” and “odds” instead of “hope” or “fight,” so you and your clinician are talking in the same lane. If helpful, preview a neutral primer like NIA’s planning page.
  • Step 3 — Confirm: Decide on code status for now and confirm it’s in the orders, not just the note. Ask for portability (e.g., POLST) if your state uses it, and set a date to revisit.

Little habits I’m testing that lower the friction

I’m not trying to become a mini-lawyer or ethicist. These small habits have simply made the conversation smoother:

  • Before the visit: I email the portal message: “I’d like to discuss resuscitation options and documentation at tomorrow’s visit.” This nudges the team to expect the topic.
  • During the visit: I bring a one-page values sheet (three bullets) and a designated health care proxy’s contact. If I’m unsure, I ask for a short follow-up specifically for goals-of-care.
  • After the visit: I open the After Visit Summary to check code status. If it’s missing or wrong, I send a clarifying note: “Can you confirm my code status is DNR/DNI as discussed and that a POLST was completed?”
  • With family: I summarize our decision in plain language, including what care continues (oxygen, antibiotics if appropriate, comfort meds). I share where the form lives on the fridge or in the chart.

What still happens if I choose DNR

I used to think DNR sounded like “do not treat.” That’s not right. DNR means that if my heart or breathing stops, the team will not start chest compressions, electric shocks, or intubation aimed at resuscitation. It does not cancel routine or comfort care. In many cases, I can still receive oxygen, IV fluids, antibiotics, noninvasive breathing support (if aligned with DNI status and goals), and aggressive symptom relief (for pain, breathlessness, anxiety). If I’m ever unsure, I ask directly: “What care continues under DNR?” and I request that examples be written in the note for clarity.

Common pitfalls I’m trying to avoid

  • Equating DNR with “no care.” Instead, I ask the clinician to list what continues.
  • Assuming one conversation covers it forever. I set calendar reminders to revisit after big health changes.
  • Forgetting portability. I ask about a state-approved out-of-hospital form or POLST so EMS and facilities can honor decisions.
  • Being too general. “No heroics” means different things to different people; I use precise terms like CPR, intubation, shocks, ICU transfer.
  • Not naming a proxy. I complete a health care proxy/agent form and share contact info.

Neutral starters you can tailor to your voice

Here’s a compact list you can copy, paste, and edit. I rotate these depending on the moment:

  • “Could we talk through CPR in the context of my goals so I understand benefits and burdens?”
  • “If my heart stops, what are the realistic outcomes for someone like me?”
  • “I’m leaning toward DNR because staying comfortable and at home matters most. Does that align with what you see medically?”
  • “If I choose DNR, what parts of care continue and how will that be documented?”
  • “Can we complete any portable forms (like a POLST) so EMS and nursing facilities can follow this?”
  • “If I change my mind later, what is the process to update the order?”
  • “Could we schedule a dedicated goals-of-care visit to involve my health care proxy?”

Signals that tell me to slow down and double-check

Whenever I hear certain phrases—or feel certain feelings—I take it as a cue to pause and ask for clarity:

  • Red/amber flags in plain English: “There’s a small chance,” “Unlikely to return to baseline,” “High risk of ICU and long recovery,” “Limited benefit from CPR.” These are invitations to ask for numbers in ranges and examples in my situation.
  • Preference-sensitive vs. evidence-driven: If the data are mixed for someone like me, I ask for a values-first approach; if the evidence shows CPR is very unlikely to help, I ask the clinician to say that plainly.
  • Records to keep: A photo of signed forms on my phone; copies on the fridge; a note in my care plan that says who has the original; my proxy’s confirmation they know my wishes.

For general, non-legal education, I like to review patient pages from national groups before I sign anything, then ask my clinician to translate that into my actual orders. If I’m in the hospital, I clarify with the admitting team how code status is communicated across shifts and how it’s verified during handoffs.

What I’m keeping and what I’m letting go

I’m keeping a commitment to plain language, written documentation, and revisiting decisions when my health changes. I’m letting go of the idea that I need perfect words or a perfect plan before I speak up. The best conversation is the one that happens—brief, respectful, and grounded in what matters to me. When I feel wobbly, I reread a few trustworthy primers—like the NIA overview, an ethics summary from the AMA, and a state-law orientation from NCSL—then I return to my clinician with a short list of questions.

FAQ

1) Is DNR the same as refusing all treatment?
Answer: No. DNR focuses on not starting CPR (chest compressions, shocks, resuscitation intubation) if the heart or breathing stops. Many treatments can continue if they fit your goals (e.g., comfort measures, oxygen, antibiotics when appropriate). Ask your clinician to list what continues under DNR.

2) What’s the difference between DNR and DNI?
Answer: DNR addresses resuscitation if your heart or breathing stops. DNI (do-not-intubate) usually refers to not placing a breathing tube for mechanical ventilation. Some people choose both; others choose one. Clarify which applies in your orders and how noninvasive support is handled.

3) Do I need a lawyer to complete DNR orders?
Answer: Typically no. DNR and POLST are medical orders completed with a clinician. Separate advance directive and health care proxy forms may have witnessing or notarizing requirements that vary by state. Your clinician, health system, or state health department website can provide the correct forms.

4) Will EMS honor my DNR at home?
Answer: That depends on state rules and whether you have the authorized out-of-hospital form (often a POLST or state-specific DNR) readily available. Ask your clinician how to make your order portable and visible (e.g., a bright form on the fridge, a wallet card, or registry if your state uses one).

5) How often should I revisit DNR decisions?
Answer: Revisit whenever your health status changes, after a hospitalization, or if your goals shift. Many people review annually or at major “life events.” Ask your clinician to add a reminder to your care plan so it’s not forgotten.

Sources & References

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).