ICMR Bioethics Unit

PUBLIC CONSULTATION ON DRAFT ICMR POSITION PAPER ON
‘DO NOT ATTEMPT RESUSCITATION (DNAR)’

ICMR has appointed an expert committee to draft a position paper on ‘Do Not Attempt Resuscitation (DNAR)’ which would guide treating physicians to take the decision whether or not to perform the Cardiopulmonary Resuscitation (CPR) on the background of incurable disease where the patient’s chances of survival are extremely low. The purpose of the document is to suggest a mechanism to not prolong the suffering of the patient and to preserve the dignity in death by avoiding medically non-beneficial CPR while providing compassionate care. The patient/s undergoing the treatment for incurable disease with least/no probability of survival often impose themselves and their families to increased psychological, emotional and economic burden. The document also highlights how the treating physician should provide complete information to the patient/surrogate(s) regarding DNAR and suggests a form for the purpose that can be used by clinical facilities.

It is expected that this document would help patients/surrogate(s) receive needful information and guide the treating physicians to reach a decision in the best interest of the terminally ill patient.

ICMR invites feedback and comments on the Draft ICMR Position Paper on ‘Do Not Attempt Resuscitation (DNAR)’ from relevant stakeholders. It is requested that comments/feedback pertaining to the same may be conveyed in the prescribed format by email to

Dr. Roli Mathur
Scientist F and Head, ICMR Bioethics Unit
National Centre for Disease Informatics and Research,
Indian Council of Medical Research, Nirmal Bhawan, ICMR Complex (II Floor)
Poojanhalli Road, NH-7, Kannamangala Post, Bengaluru - 562 110.
Email: icmr.bioethics@gmail.com

Note:
1. Mention “Comments/Feedback Draft ICMR Position paper on DNAR” in the subject line.
2. Give reference of page number and line number against each comment.
3. Ensure to mention full name, affiliation and correspondence address at the Email Signature.

ICMR organised a National Consultation meeting on ‘Do Not Attempt Resuscitation (DNAR)’ on 2nd December 2019 at ICMR Headquarters, New Delhi from 10.00 AM-1.30 PM. During the half day program there were three panel discussions focusing on clinical aspects, legal and patients or social perspective to help the finalization of the draft document on DNAR. We invited interested stakeholders to register online and participate in the program.

The meeting was attended by representatives from various disciplines including senior administrators, clinicians, legal experts, directors, critical care physicians, palliative care, nursing, hospice care, social scientists, patient right groups, NGO’s, ethicists, theologians, religious representatives, hospital accreditation board, industry, journal editors, public health experts, health care workers, patient and public representatives, ethics committee members, government departments, World Health Organization and communication media etc. The feedback of the multidisciplinary group was considered for revision of the Draft ICMR Position Paper on ‘Do Not Attempt Resuscitation (DNAR)’