
What to Do When a Patient Has a 'Do Not Resuscitate' Tattoo - jansho
https://www.theatlantic.com/health/archive/2017/12/what-to-do-when-a-patient-has-a-do-not-resuscitate-tattoo/547286/?single_page=true
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user5994461
It's a trivial legal question. The answer is that you resuscitate right now,
without any hesitation.

You don't want to explain to the judge that you let someone die because of a
stupid tatoo, that may very well come from 10 years ago.

~~~
criddell
A 10 year old tattoo can be easily covered up or altered if the person changes
their mind. This tattoo was clear and explicit and contained a signature.
There wasn't any ambiguity.

Would you say the same thing about a 10-year old signed card in their wallet?

~~~
Lon7
I know I guy who has "Rape Me" tattooed on his chest. It's his favorite
Nirvana Song. For the most part, tattoos are a form of art and expression.
Phrases such as "death wish" or "kill me" are pretty common, and are
absolutely not meant as instructions. The idea of DNR is pretty popular in
certain artistic circles. There is an incredible amount of ambiguity in this
situation.

~~~
criddell
Actions often have consequences. I don't see this situation any differently.

~~~
darpa_escapee
You don't see the difference between the aesthetics of a "Rape Me" tattoo and
explicit instructions?

~~~
criddell
Of course I do. I'm talking about the consequences of getting the words "DO
NOT RESUSCITATE" applied to your body along with your signature.

That said, there are lots of situations where I think it would be stupid to
have "Rape Me" tattooed to my body. It might have lots of calligraphic merit,
but if it's on your face, you probably aren't going to be working the customer
service counter at Target.

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sp332
The majority of suicide attempts are driven by temporary situations.
Postponing a suicide attempt usually means the person will reconsider.
[http://www.nejm.org/doi/full/10.1056/NEJMp0805923](http://www.nejm.org/doi/full/10.1056/NEJMp0805923)
Are there any such studies on people reconsidering their DNR?

~~~
sigzero
I believe there was at least one person that had a tattoo but "didn't think
people would considerate it serious because he wasn't". I would side on "be
cautious" when a life is at stake. If you're serious...fill out the damn
paperwork.

~~~
sp332
But it's a similar problem even with paperwork - someone might realize, while
they're in a life-threatening situation, that they'd rather not have the DNR.
I was just wondering if it's really any different from suicide.

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lev99
I wish that these tattoos carried as much weight as a paper DNR. People that
prefer DNR currently have no way to express their wishes when outside of a
health care facility.

~~~
AdamJacobMuller
Did you read the article:

> And there’s good reason to be cautious. Back in 2012, Lori Cooper at the
> California Pacific Medical Center was caring for a (conscious) patient who
> was going to have a leg amputated, when she noticed a “DNR” tattoo on his
> chest. The man revealed that he got the tattoo after losing a poker bet many
> years ago, and actually, he would very much like to be resuscitated if the
> need arose. “It was suggested that he consider tattoo removal to circumvent
> future confusion about his code status,” Cooper wrote. “He stated he did not
> think anyone would take his tattoo seriously and declined tattoo removal.”

~~~
jstanley
Well that guy's an idiot then. That one guy is an idiot shouldn't prevent
anyone else from declaring a near-permanent DNR...

He should have it covered up if he doesn't mean it.

~~~
xg15
Why is he an idiot?

The tatoo is not legally binding. It never was. As stated in the article, it
can't even give the kind of reassurance that is required by law (indication of
rational descision)

Why should he have expected that it works?

~~~
rhizome
Regardless of whether it's legally binding, what we see here is an anecdote
where there was a delay in treatment. Why should he expect that it would be
ignored? People get serious tattoos all the time:
[https://www.google.com/search?q=medic+alert+bracelet+tattoo](https://www.google.com/search?q=medic+alert+bracelet+tattoo)

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tomatsu
There are probably some people who go with the DNR route because the
healthcare system isn't that great in the US. They might prefer being 6 feet
under over being crushed by debt.

[https://en.wikipedia.org/wiki/Medical_debt](https://en.wikipedia.org/wiki/Medical_debt)

> _70 million Americans either have difficulty paying for medical treatment or
> have medical debt._

~~~
crispyambulance
The main reason to go DNR is for quality of life concerns. Once an elderly
person has already been impaired by a stroke or some other chronic condition,
adding more "medicalized" life-extension on top of that is cruel.

24-7 skilled nursing care is a miserable way to exist, regardless of who pays
the US ~ $10K/month bill.

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michaelt

      “Paper gets lost, and some people do not trust paper. This
      man may have been trying to safeguard against that
    

He was wise to distrust, as it turns out, given that they decided to
temporarily ignore the tattoo despite the fact there was a valid form on file
for him.

~~~
katet
Given that he was "He was alone and had no identification.", I don't find that
particularly malicious on their part. If I _was_ stupid enough to get a DNR
tattoo without being totally serious (like the 2012 fellow mentioned in the
article), I would hope they take the time to find out who I am and where my
file is first.

~~~
fjsolwmv
Taking the time means killing people, though.

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killjoywashere
I think I might get a similar tattoo, but with a URL, QR code, and a chip. The
url and QR code will point to a github repo with my DNR. Which I will sign
with a "No really, I mean it" statement that is cryptographically signed,
maybe once a day, once a week, something like that. The chip will also have
the key to authenticate the git signatures. And, in the DNR, I will have
directions to contact my pre-paid attorney, with further direction to summon
them to the ICU and make sure my wishes are carried out.

~~~
creep
For curiosity's sake, if you're comfortable telling me, why would you not want
to be resuscitated?

~~~
Simon_says
The people who go to the trouble to get a DNR usually have pretty poor quality
of life. Given the trauma of a resuscitation with broken ribs, possible brain
damage from a minute or two without oxygen, they think that their quality of
life might be even lower post-resuscitation, and frequently they're not even
buying that much additional time. They might think that dying with some
dignity and less pain is better than holding on for a couple more miserable
days.

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divbit
[If I put a do not resuscitate tatoo on my blind friend is that a
paddling](philosoraptor.gif)

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xg15
So, if I work in a tatoo parlor and don't like someone, I can just tatoo DNR
on their back and let things sort themselves out?

