Tattoos and resuscitation orders.

[Tony64]

Interesting article and an unusual ethical dilemma...

https://www.google.com/amp/www.nydai...icle-1.3672864

Any medical professionals or tattoo aficionados care to weigh in?

[Thatguy]

His wishes seem pretty clear to me.


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[superdog]

Saw that.

Agree it was best to abide his wishes.

[TK-710]

Originally Posted by Thatguy

His wishes seem pretty clear to me.


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I agree. Seems hard to fathom that anyone would get that tattoo and not mean exactly that.

[Star Ferry]

They should have brought him back IMO.

It's entirely possible he got the tattoo because he thought the phrase was edgy/cool. It could even be a song lyric.

[T4ME]

could be the makings of future litigation

[CDNWatchNut]

They made the right decision IMO. Anyone who gets that tattooed on their chest will have thought of the implications and how it would be interpreted, thus had the tattoo done with intent.

[Tony64]

Ok, Devil's advocate here. How many have a ex-girlfriend/boyfriend's name tattooed? Did you later have it removed?

I agree his intent seems pretty clear, but what if he'd changed his mind and hadn't gotten the ink removed?

Tough call, I can see both sides. Trouble is that one decision is irrevocable. Still you've got to respect his wishes... I'm completely conflicted on this one!

[Thatguy]

Originally Posted by Tony64

Ok, Devil's advocate here. How many have a ex-girlfriend/boyfriend's name tattooed? Did you later have it removed?

I agree his intent seems pretty clear, but what if he'd changed his mind and hadn't gotten the ink removed?

Tough call, I can see both sides. Trouble is that one decision is irrevocable. Still you've got to respect his wishes... I'm completely conflicted on this one!

I don’t see this as any different than having signed a dnr order and then changing your mind but not having to gotten around to changing it. So all DNRs should be ignored in case the patient changed their mind?



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[Tony64]

Originally Posted by Thatguy

I don’t see this as any different than having signed a dnr order and then changing your mind but not having to gotten around to changing it. So all DNRs should be ignored in case the patient changed their mind?



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No, I see your point and I agree. It's just an unusual situation and thought I'd ask the forum for opinions.

Your view seems very logical and it does appear that he went to significant effort to make his wishes clear and highly visible. Much more so than a piece of paper that could be lost or inaccessible. Who keeps that kind of paperwork with them anyway? His solution seemed bulletproof. Interesting that the doctors didn't initially honor his instructions...

[greggsiam]

A signed dnr means exactly one thing, nothing else. A tattoo can mean anything from edgy hipster, to just another crappy tattoo. But, if you actually want a legal dnr, you would fill out the paperwork, not rely only on a tattoo.

It's all moot since the guy had a legal dnr document filed. I would resuscitate the guy unless there was a legal binding dnr on record just because you can never go back if wrong.

[Tony64]

Originally Posted by greggsiam

A signed dnr means exactly one thing, nothing else. A tattoo can mean anything from edgy hipster, to just another crappy tattoo. But, if you actually want a legal dnr, you would fill out the paperwork, not rely only on a tattoo.

It's all moot since the guy had a legal dnr document filed. I would resuscitate the guy unless there was a legal binding dnr on record just because you can never go back if wrong.

Thanks Gregg, that was my initial thought as well, but the counterpoint is quite compelling.

Curious, are you a healthcare worker and have you actually encountered a situation like this?

[Tri-Tip]

If I were in that situation, I would NOT rely on the tattoo as an official DNR.

Could have it just to be a bad-ass or possibly changed his mind but could or did not get it removed.

[CDNWatchNut]

Originally Posted by Tri-Tip

If I were in that situation, I would NOT rely on the tattoo as an official DNR.

Could have it just to be a bad-ass or possibly changed his mind but could or did not get it removed.

hmmm, not being in the medical or legal profession here, I didn't think of the liability risk of not following an official protocol. So, perhaps morally the right decision, but legally not.

[SDRider]

Originally Posted by Tri-Tip

If I were in that situation, I would NOT rely on the tattoo as an official DNR.

Could have it just to be a bad-ass or possibly changed his mind but could or did not get it removed.

I think this is about the amount of thought that goes into most tattoos. I know this will probably be an unpopular sentiment but I think tattoos are ridiculous and I’m happy that I was never dumb enough to get one.

[GB-man]

Agree with Greg. That is a tattoo not a legal document. End of story.

[Star Ferry]

Originally Posted by SDRider

I think this is about the amount of thought that goes into most tattoos. Personally, I think tattoos are ridiculous and I’m happy that I was never dumb enough to get one.

Grabbing my popcorn now

[Tony64]

Not sure if this makes any difference to anyone, but I looked up the source report from the New England Journal of Medicine and his "Do Not Resusitate" tattoo was accompanied by his tattooed signature.

The article fails to mention however if his signature was notarized and if the notary's signature was tattooed as well.

http://www.nejm.org/doi/full/10.1056...3344#t=article

"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."

[Tony64]

Originally Posted by SDRider

I think this is about the amount of thought that goes into most tattoos. I know this will probably be an unpopular sentiment but I think tattoos are ridiculous and I’m happy that I was never dumb enough to get one.

Originally Posted by Star Ferry

Grabbing my popcorn now

Please, no. Do not engage.

I really don't want this to devolve into a point/counterpoint on the merit/demerit of a tattoo. I'm hoping we can stick with the topic at hand. It seems sufficiently controversial in its own right.

[worldfamoussam]

I think if it were something removable like a medical bracelet it would manifest the intention much more clearly. This is a real conundrum ...

[Art 1]

Originally Posted by SDRider

I think this is about the amount of thought that goes into most tattoos. I know this will probably be an unpopular sentiment but I think tattoos are ridiculous and I’m happy that I was never dumb enough to get one.

I agree.

[greggsiam]

Originally Posted by Tony64

Thanks Gregg, that was my initial thought as well, but the counterpoint is quite compelling.

Curious, are you a healthcare worker and have you actually encountered a situation like this?

No not at all, just my thoughts. I am an IT guy so I only resuscitate dead servers.

[TK-710]

I remember when I was in the hospital in the green zone in Iraq talking with a doctor who had DNR written on his running shoes. I thought it was weird because I figured if anything catastrophic happened he would have been blown right out of his shoes. Whether or not the tattoo in itself would be binding it’s definitely a good way of making your wishes known so if nothing else they check your charts. It worked in this case very well not sure a wrist band or something on your shoes would work as well in every case.

[subtona]

Interesting replies.

A family member or a letter will suffice as a DNR but a tattoo would have to be decided/ interpreted by the courts and could be challenged by the family just because. Tattoo = resuscitate.

What other messages were tattooed on the victims body?
Would there be an obligation to flip him over and make sure you read the entire manifesto before making a decision ?

[brandrea]

I'm guessing there are other tattoos that wouldn't be taken literally as well

[SDRider]

Originally Posted by Tony64

Please, no. Do not engage.

I really don't want this to devolve into a point/counterpoint on the merit/demerit of a tattoo. I'm hoping we can stick with the topic at hand. It seems sufficiently controversial in its own right.

Sorry, my intent wasn’t to start a flame war. They just aren’t my cup of tea. To each their own.

Mods, you can delete my earlier comment as I can no longer edit it.

[Abdullah71601]

Originally Posted by greggsiam

A signed dnr means exactly one thing, nothing else. A tattoo can mean anything from edgy hipster, to just another crappy tattoo. But, if you actually want a legal dnr, you would fill out the paperwork, not rely only on a tattoo.

It's all moot since the guy had a legal dnr document filed. I would resuscitate the guy unless there was a legal binding dnr on record just because you can never go back if wrong.

Originally Posted by Tri-Tip

If I were in that situation, I would NOT rely on the tattoo as an official DNR.

Could have it just to be a bad-ass or possibly changed his mind but could or did not get it removed.

x3

A tattoo isn't legally binding. I've known too many people who regretted a tattoo to think that some old ink would be an affirmative defense when the family's attorney knocked on my door.

[DJ TT 2002]

I'm in the business
I've seen these in the real world.
I have not and would not make a decision based on a tattoo. I've never known a colleague to do so, either.


If a person with a possible DNR status is resuscitated, you have done no harm. Things can subsequently be de-escalated

If resuscitation is not performed, then nothing can be undone


This post is based on my personal experience only!!

[GB-man]

How long have you been a tattoo artist?

Originally Posted by DJ TT 2002

I'm in the business
I've seen these in the real world.
I have not and would not make a decision based on a tattoo. I've never known a colleague to do so, either.


If a person with a possible DNR status is resuscitated, you have done no harm. Things can subsequently be de-escalated

If resuscitation is not performed, then nothing can be undone


This post is based on my personal experience only!!

[Hooper]

A little extreme, IMHO But to each their own!