Australasian Science: Australia's authority on science since 1938

The Man with the DNR Tattoo

By Michael Cook

Should doctors follow the instructions of a tattoo when facing end-of-life decisions?

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Doctors at a Florida hospital’s emergency department were startled to discover the words “DO NOT RESUSCITATE” tattooed on an unconscious man’s chest. The word “not” was underlined. Beneath this imperative was his signature, also tattooed.

“We’ve always joked about this, but holy crap, this man actually did it,” one of the doctors who treated him said. “You look at it, laugh a little, and then go: Oh no, I actually have to deal with this.”

The 70-year-old man had no identification. His blood alcohol was high. His health was very bad, with a history of chronic obstructive pulmonary disease, diabetes and an irregular heart rate.

Should they respect the request or not? The default position for contemporary ethics is always to respect a patient’s autonomy.

Autonomy be damned, the doctors thought.

They kept him alive, invoking the principle of not choosing an irreversible path when faced with uncertainty. In a case report in the New England Journal of Medicine, they say that he was placed on antibiotics and given oxygen, an IV drip and adrenaline. But he wasn’t intubated or put on life support.

This gave them enough time to consult an expert from the University of Miami’s ethics programs. His advice was to honour the request. True, the unknown patient had not filled out Florida’s official advance directive form, but a tattoo...

The full text of this article can be purchased from Informit.