A.N.D. means “Allow Natural Death” which means Do Not Do CPR (CardioPulmonary Resuscitation) when the heart stops. It was introduced in 2000 by Rev. Chuck Meyer as an attempt replace the term “DNR” (Do Not attempt Resuscitation) which is often perceived negatively (some feel that an effective treatment is being withheld from them) and can confuse both doctors and families regarding how much care to provide: some interpret it to mean “don’t give any care at all”, when all it’s intended to indicate is “No CPR”. An order for “AND” should convey to everyone: allow me to die naturally by not doing CPR and by just keeping me comfortable when it is time to die.
On admission to a hospital, a person will receive CPR if their heart stops, unless there is an order by the doctor otherwise. To avoid having CPR, you must have an order written by your doctor: either “AND”, “DNR”, “AND/DNR”, or “No CPR”. Every hospital’s medical staff must endorse a policy which allows physicians to write the term “A.N.D.” The A.N.D. concept is being promoted by Palliative Care programs throughout the U.S.; and is currently accepted at Eliza Coffee Memorial Hospital, Lauderdale County, AL, where the author practices.