How do you deal with 'Do Not Resuscitate' tattoos?
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How do you deal with 'Do Not Resuscitate' tattoos?
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I listened to a radio programme last night about people who have Do Not Resusitate tattoos on their chest. I found a very good article by Daniel Sokol published in the BMJ about this topic. He takes u
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Forums » Open clinical » General clinical » How do you deal with 'Do Not Resuscitate' tattoos?
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How do you deal with 'Do Not Resuscitate' tattoos?
posted at 15/10/2012 10:50 AM BST
on bmj.com
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*Moderator*
Posts: 1450
First: 7/4/2011 Last: 24/5/2013 |
I listened to a radio programme last night about people who have Do Not Resusitate tattoos on their chest. I found a very good article by Daniel Sokol published in the BMJ about this topic. He takes us through a particular ethical scenario of where a patient has a DNR tattoo but there is no record of DNR in their formal medical notes. In the UK and North America, patients are legally entitled to refuse medical treatment, even if it will result in death. However, this patient was unconscious - as many potential DNR patients would be- so how do you infer whether to take the tattoo seriously? Sokol writes that we cannot know the validity of this tattoo: "Was the tattoo done several years ago during a bout of acute depression? Was it done as a joke or a dare? Or was it inscribed during a moment of lucidity?" "So what are this patient’s autonomous preferences? The answer must be that we do not know. The criminal standard of proof, “beyond reasonable doubt,” is more appropriate in this context than the much lower civil standard of “on the balance of probabilities.” A patient’s life is at stake, and the risk of getting it wrong—of failing to resuscitate contrary to the patient’s true wishes—is too high, the consequences too grave, to warrant the gamble." http://www.medicalethicist.net/documents/Tattoo%20BMJ%20PDF.pdf |
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Re: How do you deal with 'Do Not Resuscitate' tattoos?
posted at 15/10/2012 1:59 PM BST
on bmj.com
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Posts: 1271
First: 13/4/2010 Last: 23/5/2013 |
I have never seen one but have said many times that if I reach my 70th birthday I am going to get one done on myself and I will ensure that fact is recorded in my medical records |
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Re: How do you deal with 'Do Not Resuscitate' tattoos?
posted at 15/10/2012 3:02 PM BST
on bmj.com
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Posts: 579
First: 8/6/2011 Last: 22/5/2013 |
Skysteve I would suggest you not to do this as you can not know by now at what general physical condition you will be at your 70 and under what circumstances the arrest can be done . Anyway I think that the answer here depends on who is the responsibil to take the decision to resuscitate or not . In these case the only one who can think and make a decision is the doctor . The patient is in arrest , unconscious and can not tell us if he has changed his mind. In my opinion even if the patient has made a formal document where he declares that he don't want to be resuscitated this doesn't mean that I will let him die. It is doctors responsibility to decide and not of patients , as he is unconscious and can not tell if he has changed his mind at the last moment. So it is a matter of consciousness. |
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Re: How do you deal with 'Do Not Resuscitate' tattoos?
posted at 16/10/2012 1:18 PM BST
on bmj.com
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Posts: 50
First: 5/3/2010 Last: 23/1/2013 |
he/she has made that conscious (maybe stupid) decision. if he was 70 plus i would respect his decision. if he was a reasonably fit 45 i would ignore it. as a dr you do what you think is right in the circumstance, and ignore extraneous crap. |
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Re: How do you deal with 'Do Not Resuscitate' tattoos?
posted at 16/10/2012 7:42 PM BST
on bmj.com
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Posts: 69
First: 9/6/2010 Last: 16/10/2012 |
If someone has gone to the effort of having DNR tattooed on themselves then they should have the sense to go and make it legal with a DNR documented and witnessed somewhere else. Tattoos are not a 30 second job. I would never take a DNR tattoo as a serious request unless the patient was either a) conscious and able to tell me so or b) wise enough to have it documented somewhere
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Re: How do you deal with 'Do Not Resuscitate' tattoos?
posted at 16/10/2012 10:29 PM BST
on bmj.com
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Posts: 579
First: 8/6/2011 Last: 22/5/2013 |
This with the tattoo is an easy one . But In a 40 years old who has done a legal DNR document and who has a good fisical condition ' would you proceed on resuscitation or not ? If i were there i would. |
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Re: How do you deal with 'Do Not Resuscitate' tattoos?
posted at 18/10/2012 11:43 PM BST
on bmj.com
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Posts: 579
First: 8/6/2011 Last: 22/5/2013 |
May I ask something ? How the DNR act is done ? I mean the person who is asking for it ' is a person very ill , with a lot of grave and untreatable pathological conditions ? Or every person can have a legal act like this , even if is a healthy person ? |
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Re: How do you deal with 'Do Not Resuscitate' tattoos?
posted at 24/10/2012 2:40 PM BST
on bmj.com
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Posts: 2
First: 24/10/2012 Last: 24/10/2012 |
In Response to How do you deal with 'Do Not Resuscitate' tattoos?: I have done trauma care in big centers/highly urban and in the US Army (Afghanistan now). I hear and see all kinds of crap. Without a proper order-zero in battlefield and damn few in civilian ED/OR - I treat what I see make a personal decision and based on clinical evidence go the full two-miles 95 percent of the time. In the rare worst-to-best cases it's always wort the effort.
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Re: How do you deal with 'Do Not Resuscitate' tattoos?
posted at 24/10/2012 10:14 PM BST
on bmj.com
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Posts: 2
First: 24/10/2012 Last: 24/10/2012 |
In Response to Re: How do you deal with 'Do Not Resuscitate' tattoos?: he/she has made that conscious (maybe stupid) decision. if he was 70 plus i would respect his decision. if he was a reasonably fit 45 i would ignore it. as a dr you do what you think is right in the circumstance, and ignore extraneous crap. Posted by rmtracey I will be always afraid of people who judge that 1 life (eg 45 yr old) is more important than the other (eg 70). It is not for the doctor to judge it. Tattoo is not any proof - would you take seriuosly any other tattoos? |
Forums » Open clinical » General clinical » How do you deal with 'Do Not Resuscitate' tattoos?
