DNR stands for Do Not Resuscitate. It is a legal order for doctors to withhold treatment in the case of heart or breathing failure.
In the US, 80% of people say that when facing a terminal illness, they would prefer to avoid aggressive life-saving treatment. This number increases to nearly 90% among doctors. This may be because doctors are more knowledgeable about the suffering and reduced quality of life after treatments such as CPR and electric shock.
Despite these high numbers, doctors regularly give these treatments unless there is an official DNR on file. But what do they do when there is an unofficial DNR? Doctors at Jackson Hospital faced this dilemma when an unconscious patient was found to have a DNR tattoo on his chest. It said, “DO NOT RESUSCITATE” with the ‘NOT’ underlined.
The elderly patient had no ID and a high blood alcohol level. Aside from that and the tattoo, they had nothing to go on. They couldn’t find any medical records and didn’t know if the tattoo was a joke or the man’s true wishes. Dr. Holt, the physician on duty said, “We always kind of joked around about doing that. A lot of physicians say, ‘Boy, I’m going to have that tattooed on my chest so everyone knows my status’. Then you see it and…holy crap,”
If the tattoo were just a joke, it wouldn’t be the first time. In another case, a doctor noticed the letters D.N.R. tattooed on a man’s chest and asked him about it. He said he got the tattoo because he lost a bet as a young man and he didn’t think anyone would take it seriously.
In the case of the Miami man, Dr. Holt and the other Jackson Hospital doctors weren’t so sure it was a joke. The tattoo even included a signature. And Dr. Holt pointed out the placement of the tattoo on the chest was exactly the spot in which CPR treatment would be given.
There are a lot of rules for a legal DNR. In Florida, there is even a rule about the color of paper that it needs to be on. There’s nothing mentioned about tattoos. Despite this, the doctors decided that the tattoo did probably represent the man’s true wishes and should be respected. Nearly 2 hours after the decision had been made, an official DNR order on paper was found. The man died the following morning. Some would say it was a more peaceful and natural death.
Doctor Holt says of the man’s decision to get the tattoo, “It also seemed that he didn’t trust that his end-of-life wishes would be conveyed appropriately. So, to me, it means we need a better system.”