Do-Not-Resuscitate Decisions on a Psychiatric Unit

DNR decisions on a psychiatric unit should reflect adequate staff CPR training and preparation, adequate medical consultation, a thorough assessment of the patient's competency, adequate surrogate decision-making if the patient is not competent, and appropriate milieu management and education. We wish to underscore the widely held principle that DNR status should not result in the abandonment of other aspects of treatment, whether medical or psychiatric. We believe there is a limited but appropriate role for DNR decisions on a psychiatric unit.