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‘Do not resuscitate’: unconscious patient’s tattoo thrust life-and-death ethical dilemma on doctors

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This tattoo was found on an unconscious 70-year-old patient in Florida, thrusting an ethical dilemma upon doctors. The blurred section carried the man’s signature. Photo: NEJM
Associated Press

It was a scenario that emergency room doctors at Jackson Memorial Hospital had discussed but never seen in person.

The unconscious patient on the stretcher had a tattoo across his chest that read “Do Not Resuscitate.”

The 70-year-old man at the Miami hospital posed a vexing ethical dilemma and a decision needed to be made fast. His blood pressure was dropping and he wasn’t breathing well. He had a history of chronic obstructive pulmonary disease, diabetes and he had a high blood alcohol level.

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“If we didn’t do something soon we were going to lose him,” said Dr Gregory Holt, an assistant professor of medicine at the University of Miami who worked on the case this summer.

In the end, the doctors followed the directions of the tattoo but not before some hand-wringing and a quick referral to the hospital’s ethics team.

He placed it on his chest where someone would have to do chest compressions ... so we felt like this was a real accurate statement
Dr Gregory Holt

Doctors immediately had two questions about the tattoo.

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