ADRT stands for Advance Decision to Refuse Treatment. This is a decision you can make now to refuse a specific type of treatment at some time in the future. It lets your family, carers and health professionals know your wishes about refusing treatment if you’re unable to make or communicate those decisions yourself. For example, some people with severe dementia might make an ADRT to refuse any treatment to prolong their life in order to ensure they can die in a way that aligns with their preferences and values.

On the other hand, DNACPR stands for Do Not Attempt Cardiopulmonary Resuscitation and it is a medical order written by a doctor. It instructs healthcare providers not to do cardiopulmonary resuscitation (CPR) if a patient’s breathing stops or if the patient’s heart stops beating. This is a specific decision about CPR, not about any other treatments. You can very well have a DNACPR decision but still receive all other treatment and care.

So, in simple terms, the difference is that an ADRT is a broader decision covering any kind of treatment refusal that you wish to specify for the future, while DNACPR is a specific order made by a doctor about not performing CPR. These two can work together to ensure your wishes about your healthcare and treatment are respected. For example, you can state in your ADRT that you would like a DNACPR order to be in place in the event of your sudden cardiac or respiratory arrest.

In any case, whether setting up an ADRT or discussing DNACPR, it is important that these decisions are suitability communicated and shared with all relevant parties including family, carers, and healthcare professionals to ensure your wishes are known and can be acted upon when needed.

Following on from our discussion about the differences between Advance Decision to Refuse Treatment (ADRT) and Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR), you might now be wondering:

1. Can I have both an ADRT and a DNACPR?
2. Can an ADRT overrule a DNACPR or vice versa?
3. How do I make an ADRT or a DNACPR?
4. When should an ADRT and/or DNACPR be reviewed?
5. Can I have both an ADRT and a DNACPR?
   Yes, you can have both an ADRT and a DNACPR. These documents complement each other as they serve different, but interrelated, purposes. Whilst an ADRT allows you to make decisions about your medical treatments in advance, a DNACPR specifically instructs medical staff not to attempt cardio-pulmonary resuscitation if your heart stops or if you stop breathing.
6. Can an ADRT overrule a DNACPR or vice versa?
   No, an ADRT cannot overrule a DNACPR and vice versa. Each applies to different situations and can co-exist without conflict. The ADRT sets out the treatments you would want, or not want, if you were unable to express your wishes at a certain time in the future. The DNACPR, on the other hand, focuses specifically on not attempting CPR in the event of cardiac or respiratory arrest.
7. How do I make an ADRT or a DNACPR?
   For an ADRT, you can make one yourself, or use a service such as myADRT. The process involves documenting your wishes regarding refusal of specific treatments under certain conditions. This could be, for instance, refusing life-sustaining treatment if you were in a permanently unconscious state. The ADRT must be signed, dated, and witnessed.

The DNACPR order, however, is made by doctors who will consider your current health status, prognosis, and the likely outcome of CPR. If you have strong feelings about this, it is important to discuss them with your physician, who can then factor in your wishes with all clinical considerations.

4. When should an ADRT and/or DNACPR be reviewed?
   Regular reviews of both the ADRT and DNACPR are crucial to ensure that they align with your current health condition and personal wishes. If your health situation changes significantly, or you change your mind about your treatment preferences, these documents should be reviewed and updated accordingly. You should always discuss updates with your healthcare provider to ensure that they are aware of your latest wishes. In the case of myADRT, revisions can be made directly on the website.

If you are considering creating an ADRT or updating an existing one, we encourage you to register your ADRT form with myADRT by visiting https://myadrt.com/register/  By registering with myADRT, you can ensure that your document is created, stored, and shared more efficiently with healthcare professionals and trusted individuals involved in your care.

Additionally, please consider sharing the myADRT service with your friends, family, or loved ones who may also benefit from having an ADRT in place. By spreading the word about this valuable service, you can help others take control of their future medical care and ensure their wishes are respected even when they are unable to communicate them personally. Registering an ADRT with myADRT is a proactive step towards peace of mind for both you and the people who care about you.