Man’s ‘Do Not Resuscitate’ tattoo poses quandary

Doctors unsure whether to take the ink seriously

An unconscious 70-year-old man was rushed to an emergency room in Miami 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 quandary — 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,” wrote Gregory Holt, a doctor at the University of Miami Hospital and one of the paper’s authors.

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

Doctors first decided not to honor the unusual DNR request. But they were conflicted enough to ask for an ethics consultation. The consultants disagreed with their decision.

Social workers later used the man’s fingerprints to track down his DNR paperwork, which supported the end-oflife 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.

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

NEW ENGLAND JOURNAL OF MEDICINE A medical ethicist says a tattoo such as the one on this Miami patient is a good way to back up a living will or an advanced directive.