Patient's 'Do Not Resuscitate' Tattoo Leaves Doctors With Dilemma

The New England Journal of Medicine
The New England Journal of Medicine

They weren't sure of the legality of the written statement on his chest.

Doctors at a Florida hospital faced an ethical dilemma after reading the tattoo of a patient who had collapsed.

The words “DO NOT RESUSCITATE” were inscribed across the 70-year-old man’s chest, reports said.

The unidentified man was taken to Jackson Memorial Hospital earlier this year and when doctors spotted the ink, they were left pondering legal and ethical questions.

The man, who was unconscious, had a series of medical issues. He was without identification or family when he arrived. The patient lived in a nursing home, but was found intoxicated and unconscious on the street, reports said.

A report, which was featured in New England Journal of Medicine, said that doctors initially chose not to honor the tattoo, “invoking the principle of not choosing an irreversible path when faced with uncertainty.”

They placed him on antibiotics, and he received intravenous fluid resuscitation and vasopressors, but doctors later changed their mind. 

“After reviewing the patient’s case, the ethics consultants advised us to honor the patient’s do not resuscitate (DNR) tattoo,” the report read.

“They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients’ best interests,” it continued.

Doctors wrote a DNR request, after which the social work department obtained a copy of the patient’s Florida Department of Health “out-of-hospital” DNR order.

The man died that evening.

The authors of the report found that the tattoo created more confusion that clarity.