Date Published

December 20, 2013

Updated For

ALS PCS Version ALS PCS Version 5.2


Question: I was told by a physician that a DNR becomes void with a suicide attempt. I was wondering how we should approach this situation.


 This is an interesting question and hopefully a rare clinical situation. Suicide specifically is not addressed in the MOHLTC Training Bulletin on the DNR Standard.

One of the first issues with this clinical scenario (DNR/Suicide patient) would have to be: who is it that activated 911? If there is a family member or other individuals who are present on scene demanding that CPR be initiated, then this is addressed by the MOHLTC training Bulleting on the DNR Standard.

In Section 1 A point #2 if the DNR Standard it states: A paramedic WILL initiate CPR on a patient who has experienced a respiratory or cardiorespiratory arrest when the substitute decision maker (SDM) has rescinded a valid DNR confirmation form by stating he/she wishes CPR to be performed or there is confusion as to who the SDM is and/or one or more people present at the time is demanding that CPR be initiated on the patient.


If there are no bystanders present on scene but somehow 911 was activated (perhaps by the patient themselves prior to self-harm) the other consideration would be to patch to the BHP for further direction in this rare situation.



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