The Final Day: What Happens Without a Pre-Existing Do Not Resuscitate Order?

Weaver, Meaghann S; Liang, Jia; Cohen, Abagail D; Li, Cai; Johnson, Liza-Marie · J Pediatr · 2026

case_series · Level IV

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Abstract

Children with cancer may not have a do not resuscitate (DNR) order, yet absence rarely guarantees cardiopulmonary resuscitation (CPR). In a review of 344 inpatient deaths over a decade, 85% had DNR orders; 20% received CPR, mostly for perceived reversibility. Intensive care unit location and active chemotherapy were associated with fewer DNR orders. Families often declined CPR, despite absence of a DNR order, when death was imminent.

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