Emergency room medical doctors at a College of Miami hospital confronted a vexing moral dilemma when paramedics wheeled in an unconscious man with a “Do Not Resuscitate” chest tattoo.
The case is described in a case research revealed Thursday within the New England Journal of Drugs.
Medical doctors treating the 70-year-old diabetic affected person at first started lifesaving efforts. The affected person had an elevated blood alcohol stage and a historical past of pulmonary illness.
However tattooed “don’t resuscitate” requests will not be thought of legitimate by the Florida Division of Well being and the medical doctors had been unable to right away find the person’s members of the family and even determine him.
“We initially determined to not honor the tattoo, invoking the precept of not selecting an irreversible path when confronted with uncertainty,” the College of Miami medical doctors write within the case research.
In order that they started administering antibiotics and intravenous fluids.
“This determination left us conflicted owing to the affected person’s extraordinary effort to make his presumed advance directive identified,” the medical doctors write. “Due to this fact, an ethics session was requested.”
Ethics consultants quickly suggested the medical doctors that the tattoo probably represented his needs and must be honored.
The consultants informed the physicians that “the regulation is typically not nimble sufficient to help patient-centered care and respect for sufferers’ finest curiosity,” in keeping with the medical doctors.
After a DNR order was written, officers discovered an official copy of the person’s DNR order from the Florida Division of Well being. He died in a single day with out additional lifesaving efforts, the medical doctors write.
“We had been relieved to seek out his written DNR request, particularly as a result of a evaluation of the literature recognized a case report of an individual whose DNR tattoo didn’t mirror his present needs,” the medical doctors add.