Background and Aim: A precise understanding of the Do Not Resuscitate (DNR) order is essential for ethical decision-making and providing care aligned with the wishes of end-of-life cancer patients. This study aimed to analyze the concept of DNR using Rodgers' evolutionary model.

Methods: This concept analysis was conducted based on Rodgers' evolutionary approach. Through a systematic search in international and Iranian scientific databases from 1980 to 2024, data from 85 relevant articles were extracted and analyzed.

Results: Four main attributes of DNR were identified: 1) a formal medical order, 2) limited to the prohibition of cardiopulmonary resuscitation (CPR), 3) specific to the context of end-of-life illness, and 4) based on patient autonomy and shared decision-making. Key antecedents included the diagnosis of an end-of-life illness, effective communication, and care planning. Outcomes were both positive (a dignified death, reduced suffering) and negative (moral distress, conflict). The concept of "Allow Natural Death" (AND) was suggested as an alternative term.

Conclusion: This analysis defines DNR as a dynamic and communicative process in end-of-life cancer care. The results emphasize the necessity of early, compassionate, and team-based conversations with cultural sensitivity to respect patient wishes and facilitate a dignified death.