DNR Order Form (India)

A DNR Order Form in India captures the information the relevant authority needs for the matter it concerns and creates a dated written record of what was submitted.

A DNR order does not mean the withdrawal of all medical care — it applies specifically to resuscitation efforts. The patient continues to receive other appropriate care, comfort measures, pain management, and treatment for conditions other than cardiac or respiratory arrest. The DNR is a targeted instruction about one specific clinical intervention, not a general withdrawal of treatment.

The Supreme Court's landmark judgment in Common Cause v. Union of India recognised a competent adult's fundamental right under Article 21 of the Constitution of India to refuse medical treatment, including CPR, as an expression of personal bodily autonomy. The Court laid down detailed procedural guidelines for executing a valid Advance Medical Directive and for constituting the Medical Board that must review the directive before effect is given to it.

Regulation 6.7 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002 requires physicians to obtain informed consent before initiating or continuing life-prolonging treatment and acknowledges the right of competent patients to refuse treatment. The National Medical Commission Act 2020, which replaced the Indian Medical Council Act 1956, continues these professional conduct obligations under the National Medical Commission (NMC).

The DNR form is prepared by the treating physician in consultation with the patient and family, documented in the patient's medical record, and reviewed periodically during hospitalisation. For a DNR instruction to be legally effective, it should be signed by a competent patient or incorporated into a valid AMD countersigned by a Judicial Magistrate of First Class (JMFC) per the Supreme Court guidelines.

The Mental Healthcare Act 2017 established advance directives specifically for mental health treatment under Section 5, allowing persons with mental illness to specify treatment preferences and appoint a nominated representative. While the Common Cause 2018 judgment addressed physical health AMDs and DNR instructions, the Mental Healthcare Act 2017 provides a parallel statutory framework for mental health directives — reflecting India's broader recognition of patient autonomy across healthcare settings.

In practice, many Indian hospitals — particularly tertiary care institutions in metropolitan areas — have developed internal DNR protocols aligned with the Common Cause guidelines. The hospital's Ethics Committee typically reviews DNR decisions where there is family disagreement or uncertainty about the patient's wishes. Patients and families who receive a DNR recommendation from the treating team should be informed about their right to seek a second medical opinion and to request Ethics Committee review before any DNR order is given effect. Forms-legal.com provides this DNR Order Form template as a starting point for India-compliant advance care planning documentation.

You need a DNR Order Form when a terminally ill patient, or a patient in permanent vegetative state, or a patient with end-stage organ failure, wishes to refuse CPR and related resuscitative interventions. The form should be completed before a medical emergency occurs — ideally as part of thorough advance care planning alongside an Advance Medical Directive and Healthcare Proxy.

The India DNR Order Form (India) form is essential for communicating the patient's wishes clearly to hospital staff, emergency responders, and any healthcare facility where the patient may be treated. Without a documented DNR, medical staff are legally obligated to attempt resuscitation.

The form should be kept with the patient's medical records at the treating hospital and should be accessible to any care provider who may treat the patient.

Parties in India should prepare a DNR Order Form (India) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under Indian law, the Indian Contract Act 1872 governs contractual obligations, with Section 10 setting essential requirements for valid agreements. The Companies Act 2013 regulates corporate entities through the Registrar of Companies (ROC) and Ministry of Corporate Affairs (MCA). The Industrial Disputes Act 1947 and state labour commissioners govern employment disputes. The Information Technology Act 2000 and IT (Reasonable Security Practices) Rules 2011 protect personal data. The Income Tax Act 1961 and Goods and Services Tax Act 2017 govern tax obligations through the Central Board of Direct Taxes (CBDT) and GST Council. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.

A valid DNR Order Form in India should include the following elements to comply with the Supreme Court guidelines in Common Cause v. Union of India (2018) 5 SCC 1 and the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002.

Patient identification: Full name, age, date of birth, Aadhaar number (or other government-issued ID), medical record number, ward/bed number, and primary diagnosis. Precise identification prevents application of the DNR to the wrong patient in an emergency.

DNR instruction statement: Specific identification of which resuscitative measures are being refused — cardiopulmonary resuscitation (CPR), defibrillation, endotracheal intubation, mechanical ventilation, and artificial nutrition — distinguishing between full DNR and partial DNR (where only certain interventions are refused).

Basis of the instruction: Whether the instruction is given by a competent patient exercising their right under Article 21 of the Constitution; by a healthcare proxy implementing a valid Advance Medical Directive compliant with the Supreme Court guidelines; or by the Medical Board constituted by the hospital under the AMD framework.

Treating physician certification: The treating physician's confirmation that they have explained the nature and consequences of CPR and resuscitative interventions to the patient or proxy, that informed consent has been obtained, that the patient's condition is such that the DNR is medically appropriate, and that the physician has no objection on professional grounds.

Signatures: Patient signature (if the patient is competent at the time of signing), or Healthcare Proxy's signature with reference to the AMD; two witness signatures (witnesses must not be the treating physician, a hospital employee with authority over the patient, or a beneficiary under the patient's Will); and countersignature by the Judicial Magistrate of First Class (JMFC) if this instruction is incorporated into a formal AMD.

Hospital details: Name and address of the treating hospital or care facility; name and registration number of the treating physician under the NMC Act 2020.

Review and revocation clause: Statement that the DNR instruction may be revoked at any time by the competent patient, and the scheduled review date — DNR orders should be reviewed at each admission and when the patient's condition changes.

Data protection: Medical records containing DNR instructions are sensitive personal data under the Information Technology (Reasonable Security Practices and Procedures and Sensitive Personal Data or Information) Rules 2011 under the IT Act 2000. Hospitals must implement appropriate security measures to protect the confidentiality of DNR orders and medical records.

Medical Board constitution: Per the Supreme Court's Common Cause v. Union of India (2018) guidelines, the hospital must constitute a Medical Board of at least three specialists — including a specialist in the patient's primary condition — to examine the patient, review the AMD or DNR instruction, and confirm the medical basis for the DNR before it is given effect. The Medical Board's written opinion must be recorded in the patient's file.

High Court jurisdiction: If any doubt arises about the validity of the DNR instruction or the patient's capacity, or if family members disagree, the treating physician or hospital must approach the jurisdictional High Court under its parens patriae jurisdiction before withholding treatment. The Supreme Court in Common Cause expressly retained this judicial safety net. Forms-legal.com provides this DNR Order Form template as a starting point for India-compliant advance care planning documentation.