Do Not Resuscitate (DNR) Form (Ghana)

A Do Not Resuscitate (DNR) Form in Ghana directs which treatments the maker accepts or refuses if they become unable to communicate.

Ghanaian law does not have a specific statute governing advance directives or DNR orders in the manner of comparable legislation in the United Kingdom (Mental Capacity Act 2005) or Australia (state-based advance care directive legislation). The legal basis for a DNR Form in Ghana derives from the general principle of patient autonomy and informed consent under the Contracts Act 1960 (Act 25) — a patient who has the legal capacity to enter contracts has the right to refuse medical treatment, including resuscitation, for any reason or for no reason. The Ghana Medical and Dental Council (MDC), established under the Medical and Dental Practitioners Act 1996 (Act 526), regulates the conduct of medical practitioners and sets ethical standards for end-of-life care.

The Ghana Health Service (GHS), established under the Ghana Health Service and Teaching Hospitals Act 1996 (Act 525), is the principal public health authority in Ghana. The GHS Clinical Guidelines and the code of professional conduct published by the Ghana Medical and Dental Council provide the framework within which DNR decisions are communicated and implemented in Ghana's public hospitals — including Korle Bu Teaching Hospital in Accra, Komfo Anokye Teaching Hospital in Kumasi, and Tamale Teaching Hospital — and in licensed private healthcare facilities.

A DNR Form in Ghana must be distinguished from a Living Will (advance healthcare directive), which is a broader document addressing a range of medical treatments and conditions beyond resuscitation — including artificial nutrition and hydration, mechanical ventilation, and palliative care preferences. A DNR Form is also distinct from a Healthcare Power of Attorney, which appoints a trusted person to make medical decisions on behalf of the patient if they lose decision-making capacity, and from an organ donation directive under the Human Tissue Act 2003 (Act 645).

In the Ghanaian cultural context — where family involvement in medical decisions is deeply embedded in the social fabric of Akan, Ewe, Ga, and Northern communities — a DNR Form should be discussed with the patient's family and, where possible, with the patient's religious leader, particularly given the important role of Christian and Islamic values in healthcare decision-making in Ghana. However, under the legal principle of patient autonomy, an adult patient's properly documented DNR decision is binding on healthcare providers regardless of family objection, provided the patient had decision-making capacity when they completed the form.

A Do Not Resuscitate (DNR) Form in Ghana is required in the following circumstances to confirm that a patient's end-of-life preferences are documented and communicated to healthcare providers.

When a patient in Ghana is diagnosed with a terminal illness — including advanced cancer, end-stage organ failure, or a degenerative neurological condition — and after consultation with their doctor determines that CPR would not restore meaningful quality of life or would cause additional suffering, a DNR Form documents this informed decision. The attending physician at the patient's treating hospital — whether Korle Bu Teaching Hospital, Ridge Hospital in Accra, or a regional hospital under the Ghana Health Service — should countersign the form.

When an elderly patient in Ghana with multiple chronic conditions is admitted to hospital and their overall prognosis is poor, a DNR Form allows the patient to exercise their right of informed refusal of resuscitative treatment under the Ghana Medical and Dental Council's Code of Professional Conduct and the general principle of patient autonomy derived from the Contracts Act 1960 (Act 25).

When a patient in Ghana is receiving hospice or palliative care at a facility regulated by the Ghana Health Service (GHS) — or at home under a community palliative care programme — a DNR Form is required to communicate the patient's resuscitation preferences to all healthcare providers involved in their care, including emergency medical technicians who might otherwise be legally obliged to attempt CPR in an emergency.

When a patient in Ghana has discussed their end-of-life preferences with their family and their religious community — in keeping with the communal approach to healthcare decisions characteristic of Ghanaian society — and has reached a decision that CPR is not consistent with their values, a DNR Form records that decision in a format recognisable by hospital staff and emergency responders.

When a patient in Ghana is preparing a thorough advance care plan — including a Living Will, a Healthcare Power of Attorney, and an organ donation directive under the Human Tissue Act 2003 (Act 645) — a DNR Form is the component specifically addressing the response to cardiac or respiratory arrest and should be prepared alongside the other advance directive documents.

A valid Do Not Resuscitate (DNR) Form in Ghana must contain the following essential elements to be recognised and respected by healthcare providers.

Patient Identification: Full legal name, date of birth, Ghana Card number or passport number, residential address, and contact details of the patient. The patient's hospital registration number at the treating facility — whether a Ghana Health Service hospital or a licensed private facility — should also be recorded to allow the form to be attached to the patient's medical file.

Statement of Decision: A clear, unambiguous written statement by the patient that they do not wish to receive cardiopulmonary resuscitation (CPR) — including chest compressions, artificial ventilation, defibrillation, or emergency cardiac drugs — in the event that their heart stops or they stop breathing. The statement should specify whether the instruction applies in all circumstances or only in specified circumstances (for example, outside hospital where emergency medical services are responding).

Capacity Confirmation: A statement by the attending physician — licensed by the Ghana Medical and Dental Council (MDC) under Act 526 — confirming that the patient has decision-making capacity at the time of signing: that the patient understands the nature and consequences of a DNR instruction, has been provided with relevant medical information about their condition and the likely outcome of CPR, and is making the decision voluntarily without undue influence or coercion.

Medical Condition: A brief description of the patient's current medical condition and the clinical basis for the DNR decision — whether terminal illness, irreversible organ failure, or other condition — recorded by the attending physician. This contextual information helps subsequent healthcare providers understand the basis for the instruction.

Informed Consent Process: A record of the information provided to the patient about the nature of CPR, the likely outcomes in light of their condition, and the alternatives. Under the Ghana Medical and Dental Council's guidelines on informed consent, a patient must receive adequate information to make a voluntary and informed decision.

Healthcare Proxy or Next of Kin: The name, address, and contact details of the patient's appointed healthcare proxy or, if none has been appointed, their next of kin. Recording the family contact does not give the family member authority to override the patient's DNR decision — the patient's autonomous decision is determinative under Ghanaian law.

Physician Countersignature: Signature and date of the attending physician, their MDC registration number, and the name of the treating hospital or facility. The physician's countersignature confirms the patient had capacity, was informed, and that the DNR is consistent with the patient's clinical circumstances.

Patient Signature and Date: The patient's own signature and the date of signing. The form should be witnessed by an independent adult. The forms-legal.com DNR Form template covers all seven elements required for a Ghana-compliant advance directive recognised by healthcare providers at GHS hospitals and licensed private facilities. Patients should also consider completing a Living Will to address broader treatment preferences beyond CPR.