The undesirability of acronyms

The statement “allow natural death” (AND) is much less clear than “do not resuscitate” (DNR).1 A term that needs defining before it may be used will always be open to interpretation and misinterpretation by patients, relatives, and staff, and have different meanings in different hospitals—a disaster in the high pressure context of a cardiac arrest.

A better statement would be: “In the event of cessation of heartbeat and/or breathing, please do not attempt to perform cardiopulmonary resuscitation. No implications regarding any other care for this patient are intended by this statement.” Although long winded, this statement cannot be misinterpreted.

Perhaps what is revealed by Sokol’s analysis is that trying to abbreviate an extremely important clinical directive to three letters will always be fraught with problems.