A scale balancing medical needs and religious considerations in Saudi Arabia.

Navigating DNRs in Saudi Arabia: What You Need to Know About End-of-Life Decisions

Soraya Malik in Health & Wellness August 2025 • 4 min read.

"A comprehensive look at do-not-resuscitate policies in Saudi Arabia, addressing cultural sensitivities and patient rights."

End-of-life care presents some of the most difficult decisions in medicine. Balancing a patient's wishes, medical possibilities, and ethical considerations requires a delicate touch. In Saudi Arabia, these decisions are further complicated by unique cultural and legal factors, particularly concerning Do-Not-Resuscitate (DNR) orders.

A DNR order, also known as 'no code' or 'allow natural death,' is a legal document instructing healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's heart stops or they stop breathing. Given the sensitive nature of these decisions, guidelines vary significantly worldwide. In Saudi Arabia, the framework is rooted in Islamic jurisprudence, shaping how DNR orders are approached and implemented.

Understanding the perspectives of healthcare professionals on DNR policies is crucial to ensuring compassionate and ethical end-of-life care. A recent study explored the knowledge, attitudes, and beliefs of interns and residents in Saudi Arabia regarding DNR orders, shedding light on the challenges and opportunities in this evolving area of medical practice.

DNR Policies in Saudi Arabia: Key Aspects

A scale balancing medical needs and religious considerations in Saudi Arabia.

In Saudi Arabia, DNR orders were first formally addressed in 1988 by a fatwa (religious edict) issued by the General Presidency of Scholarly Research and Ifta. This fatwa serves as the foundation for DNR policies across the country. According to this directive, the decision to issue a DNR order is made by three specialized and trustworthy physicians, without requiring the consent of the patient or their family.

The fatwa outlines six specific situations in which a DNR order may be granted:

The patient arrives at the hospital already deceased.
The panel of physicians determines the patient's condition is untreatable and death is imminent.
The patient's condition does not make them suitable for resuscitation.
The patient suffers from advanced heart or lung disease or repeated cardiac arrest.
The patient is in a vegetative state.
Resuscitation is considered futile.

It's important to note that a DNR order in Saudi Arabia doesn't mean the withdrawal of all care. Patients still receive treatments to ensure comfort and dignity, with the exception of CPR. While the core principles of the DNR policy are generally adopted by hospitals, the application can vary, particularly regarding patient autonomy and family involvement.

Moving Forward: Enhancing DNR Practices in Saudi Arabia

The study underscores the necessity of strengthening education on DNR policies and ethical treatment of DNR patients within Saudi Arabia's medical schools and residency programs. There is a clear call for national DNR laws that prioritize patient involvement in decision-making, aligning with global ethical standards while respecting cultural and religious values. By addressing these issues, Saudi Arabia can ensure that end-of-life care honors both patient dignity and the principles of Islamic jurisprudence.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/amep.s99441, Alternate LINK

Title: Perspectives Of Interns And Residents Toward Do-Not-Resuscitate Policies In Saudi Arabia

Subject: Education

Journal: Advances in Medical Education and Practice

Publisher: Informa UK Limited

Authors: Abdullah Amoudi, Mohammed Albar, Amjed Bokhari, Sultan Yahya, Anas Merdad

Published: 2016-03-01

Everything You Need To Know

What exactly does a Do-Not-Resuscitate (DNR) order mean in the context of healthcare in Saudi Arabia?

In Saudi Arabia, a Do-Not-Resuscitate (DNR) order, sometimes referred to as 'no code' or 'allow natural death,' is a legal instruction to healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's heart stops or they stop breathing. This order doesn't mean that all treatment is withdrawn; the patient continues to receive care focused on comfort and dignity, but CPR is not administered.

Who makes the decision regarding a Do-Not-Resuscitate (DNR) order for a patient in Saudi Arabia, and is patient or family consent required?

In Saudi Arabia, the decision to issue a Do-Not-Resuscitate (DNR) order, according to a 1988 fatwa, rests with a panel of three specialized and trustworthy physicians. Unlike many other countries, neither the patient's nor the family's consent is legally required for the order to be issued. This process reflects the influence of Islamic jurisprudence on medical decision-making within the country.

Under what specific medical conditions can a Do-Not-Resuscitate (DNR) order be issued in Saudi Arabia according to the established fatwa?

According to the established fatwa in Saudi Arabia, a Do-Not-Resuscitate (DNR) order can be issued under six specific conditions: when a patient arrives at the hospital already deceased, when the patient's condition is determined to be untreatable and death is imminent, when the patient's condition is unsuitable for resuscitation, when the patient suffers from advanced heart or lung disease or repeated cardiac arrest, when the patient is in a vegetative state, or when resuscitation is considered futile. These conditions provide a framework for when a DNR order is deemed appropriate by the medical professionals.

Are Do-Not-Resuscitate (DNR) policies consistent across all hospitals in Saudi Arabia, or are there variations in their application?

While the core tenets of Do-Not-Resuscitate (DNR) policies are generally consistent across hospitals in Saudi Arabia, variations can occur, especially in the areas of patient autonomy and family involvement in the decision-making process. This highlights the ongoing need for standardized national DNR laws that respect both cultural and religious values while aligning more closely with global ethical standards regarding patient participation in end-of-life decisions.

Why is there a push for enhanced education and national laws regarding Do-Not-Resuscitate (DNR) orders in Saudi Arabia, and what impact is it expected to have?

The emphasis on strengthening education about Do-Not-Resuscitate (DNR) policies and the ethical treatment of DNR patients in Saudi medical schools and residency programs seeks to address gaps in understanding and implementation. Furthermore, the push for national DNR laws aims to prioritize patient involvement in decision-making, promoting compassionate and ethical end-of-life care that respects both patient dignity and the principles of Islamic jurisprudence. This evolution is crucial for aligning Saudi Arabia's practices with global ethical standards.