The Most Common Advice May Not Be the Best
If you’re signed up for cryonics, you’re probably already planning for the crucial moments after your clinical death—when your biological systems have begun to shut down, but the window for effective cryopreservation is still open.
You may have been told to sign a Do Not Resuscitate (DNR) order. It sounds right, doesn’t it? After all, you’re not trying to be “revived” in the traditional sense. But here’s the uncomfortable truth:
For cryonicists, a standard DNR could destroy your chances of preservation.
This article walks you through the logic, the flawed assumptions, and ultimately, the better tools—especially the POLST—that offer legal clarity, medical compatibility, and cryonics-friendly outcomes.
The Logic Behind a DNR (and Why It Backfires)
A Do Not Resuscitate (DNR) order is a legal medical directive that tells healthcare professionals:
“If my heart stops or I stop breathing, do not attempt CPR, defibrillation, or other life-saving measures.”
This is a compassionate tool for people who are terminally ill, elderly, or in decline. It helps prevent painful, futile interventions and allows for a more peaceful death.
So why do some cryonicists use DNRs?
The (Flawed) Reasons Cryonicists Sign DNRs:
- “I don’t want to be revived by normal medicine.”
That’s true—but cryonics isn’t traditional medicine. You still want CPR and other procedures to begin immediately after your heart stops, to buy time for cooling and transport. A DNR forbids that. - “I don’t want to be kept alive unnecessarily.”
That’s valid. But a DNR isn’t the only or best way to prevent life-prolonging care. You can address this in a Living Will or POLST without banning critical post-mortem procedures. - “My hospice or care facility required one.”
Yes, this happens. But it’s possible to negotiate a cryonics-modified DNR, or better, use a POLST that clearly communicates your unique intentions.
The DNR Trap: What Actually Happens
Imagine your heart stops. EMS arrives. They see a DNR. Legally, they are now prohibited from doing anything that looks like resuscitation—even if your spouse or cryonics advocate says, “Please start chest compressions, he’s signed up for cryonics!”
Unless the DNR is carefully modified and explained, they’ll stand down.
Meanwhile, your cells are dying. Irreversible ischemic damage is setting in. Time is running out.
What If You Customize the DNR?
Recognizing the risks of a standard DNR, some cryonics organizations—most notably the Cryonics Institute (CI) and Alcor—have developed versions of the DNR that are explicitly modified for cryonics purposes. These documents authorize CPR, cooling, and other stabilization procedures not to revive, but to preserve tissue viability until full cryopreservation protocols can begin. This modified DNR can serve as a strategic tool in contexts where having some DNR is helpful—for example, to gain access to hospice care or enable rapid pronouncement of legal death. However, it is crucial that any such DNR be worded carefully, ideally embedded within a larger legal and medical framework that includes a Durable Power of Attorney for Health Care, a Living Will, and a Full Body Anatomical Gift Form. Without that structure, even a modified DNR may still be misunderstood or disregarded in emergency situations.
A Slightly Better Fix: The DNR + Physician Letter
To improve the situation, some cryonicists add a physician letter to explain that their DNR does not apply to cryonics-specific procedures. It clarifies:
- CPR should still be initiated—but only to preserve perfusion, not to revive
- External cooling should begin immediately after pronouncement
- Laypeople or cryonics-trained personnel are authorized to help
This is a major improvement, and may help persuade hospice or EMS to act.
But it’s still not ideal.
Why?
Because in practice, emergency responders often don’t have time (or the authority) to read and interpret multiple documents—especially when they appear to conflict. A DNR says one thing; a letter says another. Many will err on the side of doing nothing.
The Best Option: A Cryonics-Compatible POLST
A POLST (Physician Orders for Life-Sustaining Treatment) avoids this problem entirely. And it is available in most (not all) states. A POLST is typically done when the physician or PA or NP can attest that “they would not be surprised if the patient were to die within the next twelve months.” An interesting criterion and easier to meet than the hospice standard which suggests death is likely within the next six months. For more information: https://polst.org/programs-in-your-state/
✅ Why a POLST is Superior
- It’s a single, physician-signed medical order—recognized across hospitals, EMS, hospice, and care facilities
- It explicitly authorizes CPR, ventilation, intubation, and other procedures—but only as needed to support cryonics, not traditional survival
- It allows you to opt out of unwanted interventions (like feeding tubes or ICU care) while still opting in to cooling and perfusion
- It can revoke or override prior DNRs or advance directives that would interfere
In other words, a POLST speaks the language of emergency medicine and clearly communicates your cryonics-specific goals without confusion.
Final Comparison: DNR vs. Physician Letter vs. POLST
| Feature | DNR Only | DNR + Physician Letter | POLST (Best Option) |
| CPR for perfusion allowed? | ❌ Prohibited | ✅ Allowed with explanation | ✅ Explicitly authorized |
| Clear to emergency responders? | ❌ No | ⚠️ Sometimes, not always | ✅ Yes – recognized legally |
| Risk of being ignored/misinterpreted | 🔴 High | 🟠 Moderate | 🟢 Low |
| Institutionally accepted (hospice, EMS) | ✅ Yes | ⚠️ Case-by-case | ✅ Yes – legally binding |
| Single, portable document? | ✅ Yes | ❌ No – needs attachments | ✅ Yes |
Conclusion: Don’t Let a Bad DNR Destroy Your Cryonics Plan
If you’re a cryonicist with a DNR and no clarifying documents, your preservation may be compromised before it even begins.
Here’s what to do instead:
- Avoid a standard DNR unless absolutely necessary
- If required, modify it with clear cryonics exceptions
- Add a physician letter explaining your intent
- Use a Living Will and POA-HC that reinforce your cryonics goals
- Work with your doctor to complete a POLST tailored to support cryopreservation
A POLST gives you medical credibility, legal enforceability, and real-world effectiveness when it matters most—those fragile first minutes after death.