A DNI order (Do Not Intubate) is a medical directive that instructs healthcare providers not to perform intubation or use mechanical ventilation if breathing fails.
It is typically issued or confirmed by a physician and applies in situations where assisted breathing would otherwise be initiated.
A DNI order focuses specifically on intubation and ventilation, and is often combined with a DNR order.
What a DNI order does
A DNI order provides clear instructions to medical professionals regarding assisted breathing.
It ensures that:
- intubation is not performed
- mechanical ventilation is not initiated
- your preferences are respected in respiratory emergencies
It is usually recognized in hospital and emergency care settings.
Why you need a DNI order
A DNI order is important if you have specific preferences about invasive breathing support.
Without a DNI:
- medical teams may initiate intubation by default
- decisions are made quickly in emergencies
- interventions may not align with your wishes
With a DNI order:
- your preferences are clearly documented
- unnecessary or unwanted interventions can be avoided
- medical care can better reflect your values
What a DNI order covers
A DNI order applies specifically to:
- intubation (insertion of a breathing tube)
- mechanical ventilation (use of a ventilator)
It may be combined with a DNR (Do Not Resuscitate) order, depending on the situation and documentation.
What a DNI order does NOT do
A DNI order does not:
- replace a living will
- appoint a decision-maker (see healthcare power of attorney)
- cover all medical treatments or emergency interventions
It is a specific directive limited to respiratory support.
When you need a DNI order
A DNI order may be relevant if:
- you have strong preferences about life-support measures
- you want to avoid invasive ventilation
- you are planning for advanced illness or end-of-life care
It is typically discussed with a healthcare professional.
Common mistakes
Some common issues include:
- assuming a DNR also covers intubation
- not documenting the order clearly
- not communicating preferences to family or doctors
- confusion between DNI and broader medical directives
A DNI order must be clearly documented and recognized to be effective.
Country note
The availability and legal framework for DNI orders vary by country. In many healthcare systems, they must be formally documented and confirmed by a physician.
Related documents
- DNR Order
- Living Will
- Healthcare Power of Attorney
- POLST (Physician Orders for Life-Sustaining Treatment)
Practical note
A DNI order should be:
accessible in emergency situations
documented clearly
discussed with healthcare providers
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