Should ER Staff Honor Patients’ Tattooed Medical Instructions?

Portrait of a man with naked torso and tattooesAn unconscious patient with a “DO NOT RESUSCITATE” (DNR) tattoo with his signature stumped emergency room staff at a Florida hospital, whether or not they should honor the instruction.

Doctors at the Jackson Memorial Hospital in Miami noticed the written text on the collarbone of the diabetic 70-year-old man, who arrived at the hospital with higher blood alcohol levels. The state does not recognize tattoos as valid DNR requests, yet the man’s inked body still baffled doctors.

Unanimous Confusion

Gregory Holt and the others who attended to the person did not expect that someone would choose to have DNR as their tattoo. The scenario of handling a patient with a DNR tattoo has crossed their minds, but the ER staff remained unprepared to deal with such cases until they encountered one.

The situation became more complicated since the patient did not have any IDs, aside from the absence of family members. The department contacted ethics consultants, after unsuccessful attempts of wanting the man to regain consciousness and give explicit medical care instructions. In the end, the consultants advised the staff to acknowledge the tattoo.

Ethical Practice

Experts from Emergency Staffing Solutions note that ER staffing in Florida may include training on DNR requests, which are valid after patients fill an official form. While a tattoo seems unusual, it does reflect a person’s wish. Ken Goodman, co-director of the University of Miami’s ethics programs, used this logic for not complying with the state law.

Goodman argued that people will not bother themselves to have a DNR tattoo, or any other kind, without taking time to consider the implications. It may be a strange way to communicate your preferences on medical care, but it gives a “dramatic view” of what you want, he added.

Conclusion

The confusion over the patient’s tattoo can be construed as a blessing in disguise since it allowed the ER staff to know what to do when faced with a similar case in the future.