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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2009.05.029 Byline: Laura Loertscher (a), Darcy A. Reed (a), Michael P. Bannon (b), Paul S. Mueller (a) Keywords: Cardiopulmonary resuscitation; Do-not-resuscitate orders; Informed consent; Physician-patient communication Abstract: The do-not-resuscitate order, introduced nearly a half century ago, continues to raise questions and controversy among health care providers and patients. In today's society, the expectation and availability of medical interventions, including at the end of life, have rendered the do-not-resuscitate order particularly relevant. The do-not-resuscitate order is the only order that requires patient consent to prevent a medical procedure from being performed; therefore, informed code status discussions between physicians and patients are especially important. Epidemiologic studies have informed our understanding of resuscitation outcomes; however, patient, provider, and institutional characteristics account for great variability in the prevalence of do-not-resuscitate orders. Specific strategies can improve the quality of code status conversations and enhance end-of-life care planning. In this article, we review the history, epidemiology, and determinants of do-not-resuscitate orders, as well as frequently encountered questions and recommended strategies for discussing this important topic with patients. Author Affiliation: (a) Department of Internal Medicine, Mayo Clinic, Rochester, Minn (b) Department of Surgery, Mayo Clinic, Rochester, Minn Article Note: (footnote) Funding: None., Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript., Authorship: All authors had access to the data and played a role in writing this manuscript.