In an incapacitated patient needing surgery but with a DNR, can a guardian suspend the DNR for surgery?

• A. Yes
• B. No
• C. Only with court order
• D. Not permitted

Answer: (A)

Temporary suspension of a DNR for a planned surgery is allowed when the patient cannot speak for themselves and a guardian or other surrogate is making decisions. The guardian may authorize putting CPR on hold during the perioperative period so that anesthesia and the operation can proceed, with the understanding that resuscitation preferences can be readdressed after the procedure. The DNR specifically targets CPR in the event of arrest and does not automatically block all perioperative interventions necessary for surgery. This decision is made to act in the patient’s best interests or in line with previously expressed wishes, and it should be clearly documented and communicated to the surgical and anesthesia teams. A court order is not typically required for this temporary change.