The continued use of the do-not-resuscitate (DNR) order remains very confusing to health care workers, especially when surgical intervention is undertaken either by choice or necessity. Although ethics committees can aid in clarification, and the use of advance directives can further define patient wishes, patient and family member education is necessary to ascertain what a surgical patient really desires. As technology advances, perioperative nurses will continue to be bombarded with ethical issues surrounding the DNR order. This article addresses how nurses can be proactive in obtaining answers to these difficult questions and learn how to deal with this dilemma. AORN J 67 (April 1998) 783-790.