NE Journal of Medicine:
An Unconscious Patient with a DNR Tattoo.
To the Editor:
We present the case of a person whose presumed code-status preference led him to tattoo “Do Not Resuscitate” on his chest. Paramedics brought an unconscious 70-year-old man with a history of chronic obstructive pulmonary disease, diabetes mellitus, and atrial fibrillation to the emergency department, where he was found to have an elevated blood alcohol level. The staff of the medical intensive care unit evaluated him several hours later when hypotension and an anion-gap metabolic acidosis with a pH of 6.81 developed.
His anterior chest had a tattoo that read “Do Not Resuscitate,” accompanied by his presumed signature (Figure 1) FIGURE 1Photograph of the Patient’s Tattoo Entered into the Medical Record to Document His Perceived End-of-Life Wishes.). Because he presented without identification or family, the social work department was called to assist in contacting next of kin. All efforts at treating reversible causes of his decreased level of consciousness failed to produce a mental status adequate for discussing goals of care.
We initially decided not to honor the tattoo, invoking the principle of not choosing an irreversible path when faced with uncertainty.
His beard seems well groomed. Hmmmmm.
A tattoo is not a signed DNR. If I were the hospital I’d make sure he died from his illness. It’s the fiscally responsible thing to do.
I thank God that, although there are a myriad of unethical humans, there are still ethical care-givers … they are some of the best of us
I salute you U of Miami care-givers … you did the right thing
I can see where it would be a tough call. Allow nature to take its course and be sued by the next of kin or resuscitate and be sued by the survivor.
Only in America…..where we do in fact care about life.
I’m an avid listener of Handle of the Law on KFI out of LA. One day a woman called in and she wanted to sue the hospital because she had on her records “DO NOT RESISTATE.” She was resuscitated and wanted to sue the hospital. Handle, asked what the damages were. The woman said “I wanted to die and they brought me back to life!” Handle then told her to go kill herself, but do not jump over an overpass where he was traveling and be caught in traffic! This lawyer is a piece of work! BTW, he hates Trump! He’s a piece of work!
https://kfiam640.iheart.com/media/podcast-handel-on-the-law-on-demand-HOTL/
Another example of a DNR tattoo:
https://www.theblaze.com/wp-content/uploads/2016/04/Hillary-Tat-by-Christian-Buckingham-.jpg
@Anon
That’s a kill it before it multiplies tat.
@Bad_Brad: The article states that DNR tattoo was signed. If you look closely at the picture, you will see where they blurred it out (for obvious reasons).
Had it not been signed, I doubt they would have honored it.
The article expresses concern about DNR tattoos being a permanent indicator of a temporary emotion.
The answer is that there are medical lasers that will remove that temporary emotion tattoo.
Until his heart stops beating, doctors have carte blanche to treat
As Bad Brad pointed out. A tattoo is not a DNR. I don’t care if the tattoo is signed or not.
After 30+ years as a Firefighter/Paramedic I’ve been down this road, several times. If you don’t have the actual DNR you are getting resuscitated. This is a BS story. Those Doctors never thought about not resuscitating him without a DNR in hand.
A little story from my past.
Called to home of terminal cancer patient with a DNR (a big no-no. BTW) by distraught family member who had a change of heart. Insisted that we resuscitate the patient. We did not. We were later sued by the family member for not resuscitating patient. Case was later dismissed.
The DNR order is drawn up before hand by the patient (if they are capable) their medical surrogate (everyone should have one) and the attending physician. It is posted in a conspicuous place near the patient to minimize the chance of it being misplaced.
More proof that the stupid gravitate to tattooing.
The bs here is that people can’t even choose to die as they wish. Why do I need an effin legal document? What about my God given rights? What about about my dignity? What about my bank account?
@JC: Why is a terminal cancer patient having a DNR a big no-no?
Seriously, just curious.
@Vietvet.
The problem is not a cancer patient having a DNR. The issue is calling us to a patient we can not legally touch. They specifically tell you to not call rescue when the DNR is implemented.
@a non a moose
Go to a nice quiet place away from people, lock the door, do your business. Quietly. Someone will find your body when the smell gets bad enough. Believe me. See how easy that is…
Where did he find a literate tattoo artist?