When an unconscious 70-year-old man was brought into a Miami hospital with a tattoo reading "do not resuscitate" (DNR), doctors faced an ethical quandary.
According to a report published in The New England Journal of Medicine yesterday, the man needed urgent care, but the doctors at the hospital were unsure what action to take.
"We initially decided not to honour the tattoo, invoking the principle of not choosing an irreversible path when faced with uncertainty."
Doctors were conflicted because the patient had obviously gone to "extraordinary lengths to make his wishes known", but could not be certain the tattoo represented his current legal wishes.
In the report, they state they worried the tattoo might "represent a permanent reminder of regretted decisions made while intoxicated".
"This patient's tattooed DNR request produced more confusion than clarity, given concerns about its legality and likely unfounded beliefs."
After ethical consultants reviewed the man's case, they eventually decided to honour the man's tattooed request, saying it was "reasonable to infer that the tattoo represented authentic preference".
A DNR order was given and the man's health deteriorated, until he died later in the night.
The doctors say they were "relieved" when they later found a written, legally binding form of the man's DNR.