DNR Orders in Saskatchewan: Do Not Resuscitate Rules and How They Work

A DNR (Do Not Resuscitate) order in Saskatchewan isn't something you write on a form and carry in your wallet. It's a medical order placed by a physician, and the mechanics of how it's established, documented, and followed during an emergency are specific to the province's clinical framework.

What a DNR Actually Is

A DNR is a physician-ordered directive that instructs medical teams not to perform cardiopulmonary resuscitation (CPR) if the patient's heart stops beating or they stop breathing. In Saskatchewan, DNR orders are documented as part of the broader Goals of Care Designation (GCD) system — they're not standalone forms.

When your physician designates you at a comfort care level of intervention, that designation inherently includes a DNR. You don't get a separate "DNR form" — you get a GCD that specifies the level of medical intervention appropriate for your situation, which includes whether CPR will be attempted.

How to Request a DNR

You can't self-issue a DNR. The process works through your health care directive and your physician:

1. Document your wishes in your health care directive. Write clearly that you refuse CPR and mechanical ventilation if there's no reasonable prospect of recovery (or whatever your specific preference is). The more specific you are, the easier it is for your physician to translate it into a clinical order.

2. Discuss it with your physician. Schedule an advance care planning appointment. Your doctor will review your directive, discuss your current health status, and determine the appropriate level of clinical intervention.

3. The physician documents the GCD. This includes the DNR component. The order goes into your permanent medical chart and is accessible to hospital teams across Saskatchewan through the clinical record system.

4. Include the GCD in your Yellow Sleeve. If you have a copy, place it in the SHA Yellow Sleeve on your fridge alongside your health care directive. EMS responding to a home emergency will check the sleeve and follow the documented orders.

What Happens During an Emergency

Here's the practical reality that most people don't fully grasp: if EMS arrives at your home and you're in cardiac arrest, the default protocol is to begin resuscitation immediately. Paramedics are trained to start CPR unless they have clear, documented orders not to.

A health care directive alone — even one that says "no CPR" — may not be enough in the field. EMS crews are trained to follow medical orders (a GCD with a documented DNR), not to interpret legal documents under time pressure. If all they find is a written directive with language about "no extraordinary measures," there's ambiguity about whether CPR qualifies, and the default is to resuscitate.

That's why the GCD matters: it translates your legal preferences into a clinical order that paramedics can follow without interpretation. And that's why the Yellow Sleeve matters: it puts that order physically in the hands of the crew responding to your emergency.

Can a DNR Be Overridden?

There are limited circumstances where a documented DNR might not be followed:

• The patient regains capacity and revokes it. If you wake up and tell your medical team you want full resuscitation, your current verbal wish overrides a prior order.
• The proxy or nearest relative is present and disagrees. This creates a medical-legal dispute. In practice, many clinicians will err on the side of providing treatment while the dispute is resolved, particularly if the situation is ambiguous.
• Clinical circumstances change dramatically. If the patient's condition has improved significantly since the GCD was documented and the goals of care haven't been updated, a physician may reassess.

What can't override a DNR: a family member's distress, a disagreement between family members about the patient's wishes, or a general objection to "giving up." The GCD is a medical order, and it reflects either the patient's own documented wishes or the proxy's direction based on those wishes.

DNR vs. Other End-of-Life Orders

A DNR specifically addresses CPR — chest compressions, intubation, defibrillation. It doesn't mean "stop all treatment." A patient with a DNR may still receive antibiotics, pain management, IV fluids, and other medical care. The GCD system handles this through its levels of intervention:

• Comfort care with DNR — no resuscitation, focus on symptom management and dignity
• Medical management with DNR — active treatment of reversible conditions, but no CPR if the heart stops
• Full resuscitative care — everything including CPR (this is the default if no GCD exists)

Understanding the distinction matters because families sometimes resist a DNR because they think it means "do nothing." It doesn't. It means one specific intervention — CPR — won't be attempted. Other appropriate care continues.

Setting Up Your DNR

Start with your health care directive. Document your CPR preferences in clear terms. Then discuss them with your physician to establish a formal GCD. Put a copy in your Yellow Sleeve. Upload your directive to MySaskHealthRecord and share it with the eHR Viewer.

The Saskatchewan Advance Directive & Living Will Kit includes a goals-of-care conversation card that covers CPR, ventilation, and other clinical decisions you'll need to address with your physician to get a DNR properly documented.

See more Saskatchewan guides →