A medical team at a Miami hospital wasn’t sure what to do when an unconscious man in need of immediate treatment was brought to the ICU with a tattoo saying not to resuscitate him.
Paramedics in Florida brought the 70-year-old man bearing a chest tattoo that read “Do Not Resuscitate” into the emergency room and found he had an elevated blood alcohol level in need of immediate care, according to a letter to the editor published Thursday in The New England Journal of Medicine. The man had no identification on him and the social work department was not able to contact his next of kin, according to the letter from doctors at the University of Miami.
“We initially decided not to honor the tattoo, invoking the principle of not choosing an irreversible path when faced with uncertainty,” the doctors wrote. “This decision left us conflicted owing to the patient’s extraordinary effort to make his presumed advance directive known; therefore, an ethics consultation was requested.”
“After reviewing the patient’s case, the ethics consultants advised us to honor the patient’s DNR tattoo,” Gregory Holt, lead author of this case study, told Gizmodo. “They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference.”
The social work department obtained a copy of his written do not resuscitate order filed with the Florida Department of Health. The patient died later at the hospital.
“Advanced directives of any kind do not override most recent expressed capable wish,” University of Toronto bioethicist, Kerry Bowman, told Gizmodo. “Tattoo regret is not rare.”
“My position would be if someone went to the great length of having DNR tattooed with a signature, it indicates a strong and clear wish,” Bowman added.