Man's "do not resuscitate" tattoo creates ethical dilemma for doctors

[the game]

So this was supposed to be a florida man thread. I came here to make a florida man thread. However after reading the article I was intrigued by the situation that the doctors were put in.

An unconscious 70-year-old man was rushed to an emergency room in Miami, Florida, earlier this year.

He had no identification, family or friends with him when he arrived.

However, he had a tattoo across his chest that said "Do Not Resuscitate." It included a signature.

The man's ink left doctors in an ethical dilemma — save the man’s life or honor the tattoo and let him die?

The case was published in the New England Journal of Medicine on Thursday.

"This patient's tattooed DNR request produced more confusion than clarity, given concerns about its legality and likely unfounded beliefs that tattoos might represent permanent reminders of regretted decisions made while the person was intoxicated," one of the paper's author, Gregory Holt, a doctor at the University of Miami Hospital, wrote.

The article said the man, who had a history of pulmonary disease, was taken to Jackson Memorial Hospital in a deteriorating condition that turned deadly.

Doctors first decided not to honor the unusual DNR request "invoking the principle of not choosing an irreversible path when faced with uncertainty," according to the study.

What ethics experts say

But they were conflicted enough to ask for an ethics consultation. The consultants disagreed with their decision.

"As unorthodox as it is, you do get a dramatic view of what this patient would want," Ken Goodman, co-director of the University of Miami's ethics programs told the Atlantic Journal.

Social workers later used the man's fingerprints to track down his DNR paperwork, required in Florida to make such a request legally valid, supporting the end of life wishes inked on his skin.

The unidentified patient died the next morning.

Arthur Caplan, head of the division of medical ethics at the New York University School of Medicine, told The Washington Post that a tattoo should be a binding request.

"A tattoo, I think, is best seen as a way to alert medical staff to your wishes," he said. "It’s useful to back up a living will or an advanced directive."

Caplan says there are no legal penalties if doctors ignore a tattoo, but letting a patient die without the proper documentation could cause a problem.

"The safer course is to do something," he said, noting that it puts doctors in a predicament that requires difficult decisions.

"We were relieved to find his written DNR request," the authors of the paper concluded

This would've had to been a really hard decision for the doctors. Being a bipolar patient I've often contemplating signing a DNR in case I was ever put in that situation. I personally would not want to be resuscitated. However having to decide to take this guys tattoo seriously or not couldn't have been easy for them.

https://www.usatoday.com/story/news/...ors/915916001/

[StayTuned]

resuscitate for the moment because of uncertainty

check the medical history afterwards. if it turns out he legit doesn't want to be resuscitated...

shoot him in the head, I guess?

[Valette]

A DNR should always be respected, a tattoo of a DNR is not a valid DNR. The doctors simply dont have enough information to know the validity of the tattoo. Someone could have forced him. He could have had it made as a joke. He could be regretting the tattoo. They simply cannot know. However, the tattoo should make the doctors tripple check if the patient has a valid DNR filed (which was the case in this situation). If you're unable to identify the patient, and therefore unable to look for a valid DNR, its better to "be wrong and have saved" than to "be wrong and have let die"

[Youn]

I guess he should have included a letter in his tattoo giving his reasons for requesting a DNR. I figure 5 paragraphs of explanation in ink across his entire chest and back would have possibly been enough to solidify his beliefs.

[Rustedsaint]

I agree with the doctors choice in this, I’d doubt any tattoos knowing it coulda been a results of a drunken binge or a prank by someone

[Independent voter]

I was looking for a follow up story to see if the patient was happy he was revived or he's pissed but I can't find anything.

[Shalcker]

I was looking for a follow up story to see if the patient was happy he was revived or he's pissed but I can't find anything.

The unidentified patient died the next morning.

Ultimately it didn't matter.

[Puri]

I don't see the moral dilemma here. Someone who has a tattoo on the chest that says "do NOT resusciate" is pretty straight forward.
But obviously I agree that there is a legal dilemma and the safer way is to rescusciate as a tattoo has no legal binding, so this was probably the logical thing to do.

[Krastyn]

So this was supposed to be a florida man thread. I came here to make a florida man thread. However after reading the article I was intrigued by the situation that the doctors were put in.




This would've had to been a really hard decision for the doctors. Being a bipolar patient I've often contemplating signing a DNR in case I was ever put in that situation. I personally would not want to be resuscitated. However having to decide to take this guys tattoo seriously or not couldn't have been easy for them.

https://www.usatoday.com/story/news/...ors/915916001/

People wear Medical Alert bracelets all the time to give information to doctors / paramedics to help them treat them, and these are accepted without question. The man in this case is doing the exact same thing. Telling them what treatment not to do.

[Deleted]

People wear Medical Alert bracelets all the time to give information to doctors / paramedics to help them treat them, and these are accepted without question. The man in this case is doing the exact same thing. Telling them what treatment not to do.

What if he got the DNR one 50 years ago as a joke?
I know some Alzheimer patients who tattoo their phone-numbers and ID numbers on their arms, but i also know a guy who tattooed his phone-number on his arm when he was 19.

[Krastyn]

What if he got the DNR one 50 years ago as a joke?
I know some Alzheimer patients who tattoo their phone-numbers and ID numbers on their arms, but i also know a guy who tattooed his phone-number on his arm when he was 19.

If you got it as a joke 50 years ago, and never bothered to change it, that's on you.

[Thelyron]

Considering that's also a song by Testament, maybe it just was his favorite song.

[Puri]

What if he got the DNR one 50 years ago as a joke?

If you ever got such a tatoo "as a joke", and you did not bother changing it, no matter if it was 5 days or 50 years, I think dying from that would be a fair consequence.

[mrsohta]

Who cares what they think, resuscitate them all!

[Aurrora]

I don't see the moral dilemma here. Someone who has a tattoo on the chest that says "do NOT resusciate" is pretty straight forward.
But obviously I agree that there is a legal dilemma and the safer way is to rescusciate as a tattoo has no legal binding, so this was probably the logical thing to do.

You can't really take the tattoo at face value though, maybe he just thought it was an edgy tattoo when he got it. Plus consider how many idiots are out there with tattoos in a language they don't speak that got them just because they looked cool.

[Elim Garak]

Follow the signed will, even if it's a tatoo. it's ethical and right in any circumstances, even if it was a stupid joke 50 years ago. You get what you deserve.

[Puri]

You can't really take the tattoo at face value though, maybe he just thought it was an edgy tattoo when he got it. Plus consider how many idiots are out there with tattoos in a language they don't speak that got them just because they looked cool.

Well, maybe someone wanted just to make a edgy selfie when jumping from one roof to the other and then fell to death. Actions have consequences, and you wouldn't call it edgy if it was not clear that this might have bad consequences. And it's not like he was 17.

[Krastyn]

You can't really take the tattoo at face value though, maybe he just thought it was an edgy tattoo when he got it. Plus consider how many idiots are out there with tattoos in a language they don't speak that got them just because they looked cool.

A tattoo is actually the best way to have your wishes met if you truly DNR. The medical profession just needs to come up with a standard form / style for it.

[Skulltaker]

Follow the signed will, even if it's a tatoo. it's ethical and right in any circumstances, even if it was a stupid joke 50 years ago. You get what you deserve.

A tatoo isn't a legally binding document, though. If a patient has 'I am a Fox' tatooed on his chest I'll not send him to a veterinarian either. It's also somewhat likely that the signature was done by a tatoo artist, not himself.

[Elim Garak]

A tatoo isn't a legally binding document, though.

A tatoo is just a word to describe a text/image on human body.
Written text that was signed - is a legally binding document.