Emergency room doctors in a University of Miami hospital experienced a vexing ethical dilemma whenever paramedics wheeled in an unconscious guy with a “ Do Not Resuscitate” upper body tattoo.
The case is described within a case study published Thursday in the New Britain Journal of Medicine .
Doctors dealing with the 70-year-old diabetic patient initially began lifesaving efforts. The patient recently had an elevated blood-alcohol level and a great pulmonary disease.
But tatooed do-not-resuscitate demands are not considered valid by the California Department of Health, and the physicians were unable to immediately locate the particular man’s family members or even identify your pet.
“ We initially decided not to honor the particular tattoo, invoking the principle associated with not choosing an irreversible route when faced with uncertainty, ” 4 University of Miami doctors create in the case study.
So they began administering remedies and intravenous fluids.
“ This choice left us conflicted owing to the particular patient’ s extraordinary effort to produce his presumed advance directive recognized, ” the doctors write. “ Therefore , an ethics consultation has been requested. ”
Ethics consultants soon suggested the doctors that the tattoo probably represented his wishes and should become honored.
The consultants told the doctors that “ the law is sometimes not really nimble enough to support patient-centered treatment and respect for patients’ greatest interest, ” according to the doctors.
After a DNR order was written, officials discovered an official copy of the man’ h DNR order from the Florida Division of Health. He died over night without further lifesaving efforts, the particular doctors write.
“ We were relieved to get his written DNR request, specifically because a review of the literature determined a case report of a person in whose DNR tattoo did not reflect their current wishes, ” the physicians add.