A bill in West Virginia would specify two types of DNR orders and mandate their use. This might help reduce high rates of DNR order misinterpretation.
Do-Not-Resuscitate Comfort Care Arrest (DNR-CCA)
means a code-status order indicating that the patient may receive all medically indicated or desired interventions - including diagnostics, therapies, mechanical ventilation, vasopressors, IV fluids, nutrition, and other disease-directed treatments - up until the moment of cardiopulmonary arrest; at that moment, CPR (chest compressions, defibrillation, ACLS, etc.) shall not be performed.
Do-Not-Resuscitate Comfort Care (DNR-CC)
means a code-status order indicating that the patient wishes for comfort-focused care only, with the withholding or withdrawal of all life-prolonging therapies, including but not limited to CPR, mechanical ventilation, vasopressors, hemodialysis, artificial nutrition/hydration, antibiotics for life-prolonging purposes, and invasive diagnostics or surgeries - while ensuring adequate palliative and comfort measures (pain/symptom management, oxygen for comfort, psychosocial/spiritual support, hygiene, oral intake if tolerated).
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