When a Loved One Nears the End of Life, Should They Be Intubated? What is a 'Do Not Intubate Order'? How is 'Do Not Intubate' Different from 'Do Not Resuscitate'? Choosing to Let Go is Sometimes the Deepest Farewell!

Fri, 12 Jun 2026 07:00:00 +0800

“To save, or not to save?”

When a loved one reaches the end of life and their breathing becomes weaker and weaker, the moment the doctor asks whether you want to intubate is often the most painful test for a family.

There is no standard answer to this question, but knowing more can help reduce panic and lead to a more reassuring choice.

What is a “Do Not Intubate Order”? And How is it Different from “Do Not Resuscitate”?

At the end of life, when the condition is already irreversible, excessive medical interventions sometimes only increase the patient’s suffering.

At this time, healthcare professionals often mention two terms: DNI and DNR. They are often confused, but their scopes are actually quite different:

Order	Full Name	Content
DNI	Do Not Intubate	Allows other basic resuscitation, but does not insert a breathing tube or intubate
DNR	Do Not Resuscitate	When the heart stops, no chest compressions, defibrillation, or other resuscitation is performed

Choosing DNI does not mean giving up treatment, but rather choosing a care method that prioritizes comfort.

For example, when a patient with a DNI is short of breath, the medical team will still provide oxygen masks and medication to relieve discomfort, they just will not place an invasive breathing tube.

This is also why advance care planning is so important:

Expressing one’s own wishes for the end of life while the patient is still conscious prevents leaving this heavy decision entirely to the confused family.

Once Intubated, Can the Tube Still Be Removed?

If a patient is already intubated but has reached an irreversible end-of-life stage, can the tube still be removed?

The answer is yes. In hospice care, this is called palliative extubation. Its purpose is completely different from rehabilitative extubation when the condition improves:

Extubation Type	Purpose
Rehabilitative Extubation	The illness has improved, the patient can breathe on their own, and the tube is removed to return to normal life
Palliative Extubation	The condition is irreversible, meaningless life support is withdrawn, allowing the patient to pass away naturally and comfortably

Palliative extubation is not “removing life support and waiting for them to pass,” but rather stopping futile delays and returning comfort and dignity to the patient.

During the process, the medical team will use medications to ensure the patient does not feel shortness of breath or pain, allowing the family to accompany them peacefully.

This period is also the time to embrace the “four stages of life”:

Action	Description
Expressing Gratitude	Thank you for everything you have done for us in this lifetime
Expressing Love	Say the love hidden in your heart out loud
Apologizing	Let go of regrets and grudges between each other
Saying Goodbye	Bid a proper farewell

True love is not necessarily holding on at all costs.

Sometimes, choosing to let go and ease a loved one’s suffering is actually the deepest farewell.

Discussing advance care planning with family as early as possible can reduce regrets for both the patient and the family.

Hospice Care on Health TLDRLSS

When a Loved One Nears the End of Life, Should They Be Intubated? What is a 'Do Not Intubate Order'? How is 'Do Not Intubate' Different from 'Do Not Resuscitate'? Choosing to Let Go is Sometimes the Deepest Farewell!

What is a “Do Not Intubate Order”? And How is it Different from “Do Not Resuscitate”?

Once Intubated, Can the Tube Still Be Removed?

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