Skin in the Game – Should Doctors Comply with a “Do Not Resuscitate” Tattoo?

Many patients find it difficult to communicate their end-of-life wishes to family members and doctors at critical points of time, especially if you are confronted with a sudden or unexpected ailment. There are legal documents designed to help address this important issue. For example, your estate planning attorney can draft an advance directive that tells your doctor and loved ones what kind of medical care you desire if you are incapacitated or deemed unable to make such decisions. You can also draft a do-not-resuscitate (DNR) order to be included with your advance directive. A DNR is a request not to have CPR administered if your heart stops or if you stop breathing. Your doctor should place the DNR order in your medical chart and doctors and hospitals in most states accept DNR orders.

But what if you tattoo “Do Not Resuscitate” on your body? Are doctors obligated to treat this marking as a medical directive? Well, a hospital in Florida encountered this very situation.

A man was admitted to the hospital, unconscious, with a history of serious health problems and a high blood alcohol level. He had no identification and no family accompanied him to the hospital. Oh yeah, he had “Do Not Resuscitate” tattooed on his chest.

Upon discovering the tattoo, doctors were inclined to ignore it. They reasoned that a DNR is such a serious matter, they did not want to throw caution to the wind. They were preparing to treat the patient when the hospital’s ethics consultant chimed in and recommended the doctors comply with the DNR tattoo. 

Check out this news report about the Do Not Resuscitate Tattoo

The ethics consultant suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients’ best interests, according to Another development strengthened the consultant’s recommendation. The hospital’s social work department found a copy of the patient’s “out-of-hospital” do not resuscitate order. As a result, the tattooed request was respected.

Navigating DNR Laws

The laws and regulations concerning DNR orders can be quite complex and will vary from state to state.

In Virginia, DNR orders are governed by § 54.1-2987.1(B), and states that a valid DNR order “may be issued by a physician for his patient with whom he has a bona fide physician/patient relationship as defined in the guidelines of the Board of Medicine, and only with the consent of the patient or, if the patient is a minor or is otherwise incapable of making an informed decision regarding consent for such an order, upon the request of and with the consent of the person authorized to consent on the patient’s behalf.” Although a DNR may be issued by a physician, historically an Advance Medical Directive has been the legal document that only licensed attorneys could counsel and draft for individuals.  This year, Virginia passed a law that would permit certified health professionals to counsel individuals on directives as well.  In Maryland, you should complete a Medical Orders for Life-Sustaining Treatment (MOLST) form. Keep in mind, under Maryland Statutes § 5-6081, a health care provider must sign the MOLST form to make it valid.

Speak to an Experienced Advance Medical Directive Lawyer Today

If you have questions about your Advance Medical Directive, or need this legal document drafted as part of a comprehensive estate plan, now the time to reach out to InSight Law to schedule a meeting. Sitting down with Bobby Feisee or one of the other seasoned lawyers at InSight Law to discuss your situation will be a productive and pleasant experience. The experienced attorneys at InSight Law can design a plan that perfectly matches your goals and needs, protects your assets and family, and provides you with peace of mind. Contact our office today by calling 703-654-6019 or filling out a quick contact form on our web site.