‘Do Not Attempt CPR’ and the concept of harm

In this article, the authors look at the concept of harm in relation to cardiopulmonary resuscitation (CPR) and ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) discussions. For patients with incurable, advancing illness, having discussions to ascertain their views about CPR, and suggesting and instituting advance care planning measures such as ‘Do Not Attempt CPR’ forms, is becoming standard practice in medical settings. Here, we discuss the concept of harm, and how contemporary DNACPR discussions, policies, laws and forms are changing such approaches. Definitions of harm, misconceptions of harm in relation to the procedure of CPR, six key areas in which harm can be considered in the context of CPR, and how harm can be looked at in relation to discussions about DNACPR, are presented.