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posted by mrpg on Monday December 04 2017, @03:45PM   Printer-friendly
from the Requiescat-In-Pace dept.

A 70-year-old man with an unusual chest tattoo caused doctors to call for the assistance of ethics consultants:

Emergency medicine doctors in Florida struggled to figure out how to respectfully care for an unconscious 70-year-old man with a chest tattoo that read "Do Not Resuscitate" followed by what appeared to be his signature. In a case report published Thursday in the New England Journal of Medicine, the doctors recounted:

This patient's tattooed DNR request produced more confusion than clarity, given concerns about its legality and likely unfounded beliefs that tattoos might represent permanent reminders of regretted decisions made while the person was intoxicated.

The unresponsive patient was brought to the emergency department by paramedics. He had high blood-alcohol levels and no identification or family with him. After a few hours, hospital staff saw his condition slipping. His blood pressure dropped and acids were building up in his blood. Despite the prominent tattoo, the doctors didn't know if they should trust it. They contacted social workers to try to find his next of kin and made several attempts to revive him enough to get him to confirm his wishes. But the revival attempts failed.

The consultants advised that the tattoo be treated as an authentic preference, and a Do not resuscitate order was written. Later on, the patient's official out-of-hospital DNR order was found, and it matched the preference expressed by the tattoo. The patient ended up dying later that night.

Let this be a lesson to you: Don't get an ironic "Do Not Resuscitate" tattoo.

An Unconscious Patient with a DNR Tattoo (open, DOI: 10.1056/NEJMc1713344) (DX) (PDF)


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  • (Score: -1, Troll) by Anonymous Coward on Monday December 04 2017, @03:53PM (1 child)

    by Anonymous Coward on Monday December 04 2017, @03:53PM (#605096)

    I am tattooing this on every liberal's ass in the county. Get them drunk, tat their asses, they wake up in the morning thinking they've been buggered again.

    • (Score: 0) by Anonymous Coward on Monday December 04 2017, @04:51PM

      by Anonymous Coward on Monday December 04 2017, @04:51PM (#605130)

      they wake up in the morning thinking they've been buggered again, everyone is happy!

      FTFY

  • (Score: 2) by OrugTor on Monday December 04 2017, @04:00PM

    by OrugTor (5147) on Monday December 04 2017, @04:00PM (#605100)

    The last line made me laugh. Thanks for the chuckle.

  • (Score: 2) by c0lo on Monday December 04 2017, @04:03PM

    by c0lo (156) Subscriber Badge on Monday December 04 2017, @04:03PM (#605102) Journal

    Don't get an ironic "Do Not Resuscitate" tattoo.

    Get a golden one instead - a coppery one if you can't afford golden.
    You know it makes sense - as much sense as the ironic one, whatever the ironic "Do Not Resuscitate" tattoo may mean.

    --
    https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
  • (Score: 2) by DannyB on Monday December 04 2017, @04:31PM (20 children)

    by DannyB (5839) Subscriber Badge on Monday December 04 2017, @04:31PM (#605111) Journal

    What if the tattoo is a fraternity hazing ritual?
    (but then would frat bro's even be able to spell resuscitate?)

    It seems like the doctors should err on the side of resuscitating if unsure. It is the course of action that does not commit you to an irrevocable outcome. If the patent later tells you that the DNR order is indeed genuine, the erroneous action of resuscitating the patent can still be corrected.

    -=-=-=-=-=-=-=-=-=-=-=-


    Teacher: I am going to teach you how to evenly cut a round cake so that it may be eaten by any number of people. The two requirements are:
    1. The cut cake pieces must be extremely close to equal in size.
    2. There must be nobody who complains that their piece is too small.
    First, you take 360 degrees and divide by the number . . . .

    Student (interrupting): Your approach is too complicated. If three people were wanting to eat the cake, a much simpler solution would be to cut the cake in half (as closely as possible) and shoot the third person. That way both conditions (1) and (2) are satisfied.

    Teacher: Ah, but your approach required an additional tool, the gun.

    Student: My method can be simplified by using only one tool, the knife. The third person is stabbed instead of shot. Whether this step is performed before or after cutting the cake is a matter of preference.

    Teacher: I see your approach is simpler.

    --
    To transfer files: right-click on file, pick Copy. Unplug mouse, plug mouse into other computer. Right-click, paste.
    • (Score: 1, Funny) by Anonymous Coward on Monday December 04 2017, @04:55PM (5 children)

      by Anonymous Coward on Monday December 04 2017, @04:55PM (#605131)

      Your approach is too complicated. If three people were wanting to eat the cake, a much simpler solution would be to cut the cake in half (as closely as possible) and shoot the third person. That way both conditions (1) and (2) are satisfied.

      If 3 people want to eat the cake just divide the cake equally into three (assuming they all want an equal portion).

      It may be too complicated for the stupid gun crazy muricans, but not everyone in the world is that retarded.

      • (Score: 5, Insightful) by DannyB on Monday December 04 2017, @05:58PM

        by DannyB (5839) Subscriber Badge on Monday December 04 2017, @05:58PM (#605158) Journal

        but not everyone in the world is that retarded

        You simply don't have the kind of leadership that the US has managed to achieve.

        --
        To transfer files: right-click on file, pick Copy. Unplug mouse, plug mouse into other computer. Right-click, paste.
      • (Score: 3, Insightful) by Runaway1956 on Monday December 04 2017, @06:27PM (3 children)

        by Runaway1956 (2926) Subscriber Badge on Monday December 04 2017, @06:27PM (#605175) Journal

        So, you're freaking GENIUSES in some respects. But, you're retarded in other ways. Which parts of the world were it, that trapped itself into a spider web of conflicting treaties, and started World War One? Fekkin' retards. The only reason we even bothered to help you out, TWICE, was so we could steal your women. We just aren't into necrophilia . . .

        • (Score: 3, Touché) by Virindi on Monday December 04 2017, @06:39PM (2 children)

          by Virindi (3484) on Monday December 04 2017, @06:39PM (#605182)

          Which parts of the world were it, that trapped itself into a spider web of conflicting treaties, and started World War One?

          Since that occurred most likely before anyone here was born, and it was certainly in no way orchestrated by anyone currently alive, it seems like a poor example.

          • (Score: 2) by Runaway1956 on Monday December 04 2017, @07:19PM (1 child)

            by Runaway1956 (2926) Subscriber Badge on Monday December 04 2017, @07:19PM (#605220) Journal

            I don't see how it's a poor example. Half of today's Europeans think they are master statesmen, just like they did in 1900. And, half of Americans are determined to preserve their second amendment right, just like they were in 1900. The nuts and the acorns don't fall far from the trees. (For clarification, Euros are the nuts, we're the acorns - and the squirrels love us all.)

            • (Score: 2) by NewNic on Monday December 04 2017, @10:42PM

              by NewNic (6420) on Monday December 04 2017, @10:42PM (#605368) Journal

              California has lots of nuts, though.

              --
              lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
    • (Score: 0) by Anonymous Coward on Monday December 04 2017, @04:56PM (2 children)

      by Anonymous Coward on Monday December 04 2017, @04:56PM (#605132)

      It seems like the doctors should err on the side of resuscitating if unsure.

      It's not like he's coming to court to testify any differently. Let him die, and he won't be filing any malpractice suits. Resuscitate, and he'll be around to do exactly that.

      • (Score: 3, Insightful) by All Your Lawn Are Belong To Us on Monday December 04 2017, @05:26PM (1 child)

        by All Your Lawn Are Belong To Us (6553) on Monday December 04 2017, @05:26PM (#605139) Journal

        It seems like the doctors should err on the side of resuscitating if unsure.

        It's not like he's coming to court to testify any differently. Let him die, and he won't be filing any malpractice suits. Resuscitate, and he'll be around to do exactly that.

        The estate will sue on guidance from the family.

        --
        This sig for rent.
        • (Score: 2) by DannyB on Monday December 04 2017, @05:55PM

          by DannyB (5839) Subscriber Badge on Monday December 04 2017, @05:55PM (#605156) Journal

          The estate will sue after contacting the deceased for guidance.

          This is why dead people vote and express interest in net neutrality. Dead people seem to vote against net neutrality which would be in their best interests. Ping times from the afterlife have horrible latency.

          --
          To transfer files: right-click on file, pick Copy. Unplug mouse, plug mouse into other computer. Right-click, paste.
    • (Score: 2) by All Your Lawn Are Belong To Us on Monday December 04 2017, @05:20PM

      by All Your Lawn Are Belong To Us (6553) on Monday December 04 2017, @05:20PM (#605137) Journal

      Actually it's catch-22 either way, because an erroneous act of resuscitating can only still be corrected if the patient doesn't have Return of Spontaneous Circulation. The heart starts beating and you're not going to stop it. And many people who choose a DNR path are afraid of waking up with a busted ribcage and never truly recover from the injuries and die a perceived worse death.

      Being wrong either way even when totally clear about desire and with legal orders properly filed (either way) can result in lawsuits and loss of licenses. Because the opposite wish - resuscitate at any cost - can be filed as well as part of advanced directives.

      What I've been trained on in this has morphed over the last twenty plus years. It used to be that next of kin could call a stop order no matter what. But there have been enough questionable cases (did John really want it stopped or did Jane just want to get her hands on the money and be done with John?) that today in the field it has to be a signed order and an effort has to be made to both validate the order and confirm the identity of the patient. A signed medical power of attorney might help at the hospital, but generally it is assumed that without a presigned DNR or POLST (the physician in-hospital order to not resuscitate) that you attempt resuscitation.

      There have been anecdotes of people getting those tattoos on a bet.

      Resolution would be the tricky part, but if you actually had a full legal DNR form in your jurisdiction (California's: https://emsa.ca.gov/wp-content/uploads/sites/47/2017/07/DNRForm.pdf [ca.gov] ) complete to physician and patient signature replication tattooed on your chest..... THAT would be trickier.

      --
      This sig for rent.
    • (Score: 1) by khallow on Monday December 04 2017, @05:22PM (8 children)

      by khallow (3766) Subscriber Badge on Monday December 04 2017, @05:22PM (#605138) Journal

      Student (interrupting): Your approach is too complicated. If three people were wanting to eat the cake, a much simpler solution would be to cut the cake in half (as closely as possible) and shoot the third person. That way both conditions (1) and (2) are satisfied.

      Why not stab three people and then I can have the cake for myself? If you're going to tell silly stories, then they should be stories where I have the cake.

      • (Score: 4, Informative) by curunir_wolf on Monday December 04 2017, @05:32PM (1 child)

        by curunir_wolf (4772) on Monday December 04 2017, @05:32PM (#605143)
        The cake is a lie.
        --
        I am a crackpot
      • (Score: 2) by realDonaldTrump on Monday December 04 2017, @06:27PM (5 children)

        by realDonaldTrump (6614) on Monday December 04 2017, @06:27PM (#605174) Homepage Journal

        I'll tell you, first we do the biggest Tax Cut in history. Then the cuts to Medicare happen automatically. Terrific!

        • (Score: 1) by khallow on Monday December 04 2017, @06:47PM (2 children)

          by khallow (3766) Subscriber Badge on Monday December 04 2017, @06:47PM (#605192) Journal
          Let me tell you about this one weird trick [wordpress.com] that libertarians hate! The automation is already underway.
          • (Score: 0) by Anonymous Coward on Tuesday December 05 2017, @03:23PM (1 child)

            by Anonymous Coward on Tuesday December 05 2017, @03:23PM (#605663)
            • (Score: 1) by khallow on Tuesday December 05 2017, @03:33PM

              by khallow (3766) Subscriber Badge on Tuesday December 05 2017, @03:33PM (#605668) Journal
              They're going to have to do better than $25 billion reduction per year to get Medicare costs in line with revenue, but I see the games are underfoot.
        • (Score: 3, Interesting) by DannyB on Monday December 04 2017, @08:49PM (1 child)

          by DannyB (5839) Subscriber Badge on Monday December 04 2017, @08:49PM (#605284) Journal

          How about we build a wall around the swamp and make the swamp pay for it?

          We have the best swamps. Trust me. The best most beautiful swamps. Swamps unmatched by the rest of the world. And believe me, I know my swamps.

          --
          To transfer files: right-click on file, pick Copy. Unplug mouse, plug mouse into other computer. Right-click, paste.
          • (Score: 1) by Sulla on Monday December 04 2017, @09:03PM

            by Sulla (5173) on Monday December 04 2017, @09:03PM (#605292) Journal

            I think you finally found a proposal that all sides of politics are in favor of.

            --
            Ceterum censeo Sinae esse delendam
    • (Score: 2) by etherscythe on Monday December 04 2017, @07:32PM

      by etherscythe (937) on Monday December 04 2017, @07:32PM (#605229) Journal

      What if a hazing ritual involves signing a full power of attorney document? At some point you just have to draw the line and say that either the person asking is criminally dangerous to society and lock them up, or a person willing to accede to that is too dumb to manage their own affairs and should be declared incompetent in a court of law. Perhaps both.

      --
      "Fake News: anything reported outside of my own personally chosen echo chamber"
  • (Score: 5, Informative) by Anonymous Coward on Monday December 04 2017, @04:31PM (7 children)

    by Anonymous Coward on Monday December 04 2017, @04:31PM (#605113)

    I'd be more impressed if they hadn't initially ignored the DNR. The fellow felt strongly enough about it to get a tattoo. That's got to say something. If there are people out there who are stupid enough to get "ironic DNR tattoos", well, Darwin Awards exist for a reason.

    • (Score: 3, Insightful) by khallow on Monday December 04 2017, @05:33PM (6 children)

      by khallow (3766) Subscriber Badge on Monday December 04 2017, @05:33PM (#605144) Journal
      This would not be the first time that attempting to make something more explicit backfires. The classic example is the first clause of the Second Amendment

      A well regulated Militia, being necessary to the security of a free State

      is often interpreted as a requirement (such as arguments that one needs to belong to a "well regulated militia" in order to have the right to bear arms).

      • (Score: 2) by Virindi on Monday December 04 2017, @06:50PM (5 children)

        by Virindi (3484) on Monday December 04 2017, @06:50PM (#605195)

        The classic example is the first clause of the Second Amendment

        A well regulated Militia, being necessary to the security of a free State

        is often interpreted as a requirement (such as arguments that one needs to belong to a "well regulated militia" in order to have the right to bear arms).

        Since that is NOT the current interpretation held by the courts, it seems like a poor example. A much better example (actually, many) can be found in the same document:

        The Congress shall have Power...To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes

        Or heck even:

        We the People of the United States, in Order to form a more perfect Union

        • (Score: 1) by khallow on Monday December 04 2017, @07:07PM (4 children)

          by khallow (3766) Subscriber Badge on Monday December 04 2017, @07:07PM (#605215) Journal

          Since that is NOT the current interpretation held by the courts

          The courts aren't the only ones interpreting the Constitution.

          • (Score: 0) by Anonymous Coward on Monday December 04 2017, @08:44PM (3 children)

            by Anonymous Coward on Monday December 04 2017, @08:44PM (#605277)

            Yeah but in the end thats the interpretation that matters.

            • (Score: 2) by Mykl on Monday December 04 2017, @09:16PM (2 children)

              by Mykl (1112) on Monday December 04 2017, @09:16PM (#605300)

              You do have to wonder though - why was this clause included if it was not important? From memory (I'm not a US constitutional expert), none of the earlier amendments included any 'explanatory' text in them apart from the 2nd. It stands to reason then that this should form part of the meaning of the amendment.

              But of course that would mean Obama would be allowed to come into your house and steal your guns from you. Can't have that.

              • (Score: 3, Insightful) by AthanasiusKircher on Tuesday December 05 2017, @12:47AM (1 child)

                by AthanasiusKircher (5291) on Tuesday December 05 2017, @12:47AM (#605429) Journal

                It stands to reason then that this should form part of the meaning of the amendment.

                It is important to the meaning of the amendment. However, "important to the meaning" doesn't mean that it is a restrictive clause that limits the rights of "the people" to only those of the "militia".

                none of the earlier amendments included any 'explanatory' text in them apart from the 2nd

                That's really not true. Take the beginning of the 4th, for example:

                The right of the People to be secure in their persons, houses, papers and effects, against unreasonable searches and seizures, shall not be violated

                The "in their persons, houses, papers and effects" is really explanatory. The real "meat" of the amendment is that the people are secure "against unreasonable searches and seizures," which has led SCOTUS over the years to expand definitions as technology changes beyond "papers" and "houses" to things like cars and electronics and such. (Though not always...)

                It would be more accurate to say that the 2nd amendment is the only one where there's a strong contingent that wants to read explanatory words as a restrictive clause. Obviously militias were important to the Founders; that's why they're mentioned. It's also a reminder about why the right is so important.

                An example I always give for this is just to change the wording to something less controversial:

                "A well educated Electorate, being necessary to the functioning of a democratic state, the right of the people to keep and read Books, shall not be infringed."

                In that case, I think very few people would read the text as implying that only registered voters should be able to keep and read books. Instead, it seems a broad right for "the people" is being stated, with a crucial benefit to a subset (the "Electorate") enumerated so future generations remember why this is important and one place where the right is essential.

                (By the way, I'm also strongly in favor of various gun regulation, as I've argued here in previous posts. But I also believe that to take away a lot of guns or impose very strong regulations, we'd require a Constitutional amendment -- not only because of the text of the 2nd, but also because its legislative history and similar versions of the amendment in other state Constitutions make it clear that a broad right was likely intended.)

                • (Score: 2) by Mykl on Tuesday December 05 2017, @10:31PM

                  by Mykl (1112) on Tuesday December 05 2017, @10:31PM (#605858)

                  Modded up. Great reply - very insightful.

  • (Score: 3, Insightful) by Aiwendil on Monday December 04 2017, @05:02PM

    by Aiwendil (531) on Monday December 04 2017, @05:02PM (#605133) Journal

    Clear this up, really, make sure that any healed DNR-tattoo is a valid DNR.

    Note that little "healed" part, if the medical personell can't tell if a tattoo is less than a couple of weeks old then they probably won't know enough to ressucitate you either.
    Also - gives a nice two week "window of regret" during which time you can just cross the tattoo out (visit a tattoo parlor).

    And anyone irconically tattooing wrong medicial information on themselves should be weeded out anyway (seriously: ironically tattooing "Do Not Ressucitate" on yourself is like tattooing "Has MRSA" on yourself [when false] - it is a dickmove that costs lots of money and is a burden and should be considered signing yourself up for a voluntary therapautic "mishap")

  • (Score: 2) by All Your Lawn Are Belong To Us on Monday December 04 2017, @05:31PM (5 children)

    by All Your Lawn Are Belong To Us (6553) on Monday December 04 2017, @05:31PM (#605142) Journal

    Things are different in every state but posting another reply upstream I came across a DNR form legal in California. What’s different about it is, in EMS field settings, a Medic Alert Bracelet or Necklace specifying DNR IS apparently considered a valid order there. ( https://emsa.ca.gov/dnr_and_polst_forms/ [ca.gov] ) There are also a couple of other providers of similar alerts considered equally valid. In my state I haven’t heard of that being valid – we require the signed order to be present and immediately available.

    --
    This sig for rent.
    • (Score: 2) by Runaway1956 on Monday December 04 2017, @06:33PM (4 children)

      by Runaway1956 (2926) Subscriber Badge on Monday December 04 2017, @06:33PM (#605179) Journal

      Heh. It's easy enough to go buy a bracelet, and slip it onto the wife's wrist after she's fallen and can't get up. Then, all the money is MINE MINE MINE!! Well, if the wife had any money . . .

      • (Score: 2) by HiThere on Monday December 04 2017, @07:07PM (3 children)

        by HiThere (866) Subscriber Badge on Monday December 04 2017, @07:07PM (#605216) Journal

        Those DNR bracelets aren't that easily accessible, and I think that there's generally an audit trail. That said, you could probably order one in her name using her credit card sufficiently in advance if you planned it carefully. But if that's your intent, why bother with something so complicated.

        --
        Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
        • (Score: 2) by EvilSS on Monday December 04 2017, @08:09PM (1 child)

          by EvilSS (1456) Subscriber Badge on Monday December 04 2017, @08:09PM (#605248)

          Those DNR bracelets aren't that easily accessible, and I think that there's generally an audit trail.

          $11.00 but right now has a $4.00 off coupon making it $7.00!! https://www.amazon.com/MyIDDr-Engraved-Medical-Bracelet-Stainless/dp/B01MQM2COM/ [amazon.com]

          • (Score: 2) by HiThere on Tuesday December 05 2017, @01:18AM

            by HiThere (866) Subscriber Badge on Tuesday December 05 2017, @01:18AM (#605446) Journal

            I'm a bit shocked, but your link has the price of a DNR bracelet at about $6. Still, ordering from Amazon *does* leave an audit trail, though I have my doubts as to whether anyone would follow it, and it also requires a *bit* of preparation. You'd need to plan about a week ahead of time.

            Still, at $6 there might well be a local source. That I haven't seen one may just mean I haven't been looking.

            --
            Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
        • (Score: 2) by Joe Desertrat on Monday December 04 2017, @10:17PM

          by Joe Desertrat (2454) on Monday December 04 2017, @10:17PM (#605351)

          I doubt they are going to research the origin of any such bracelet in time to save someone who needs resuscitation. Just make sure it is not traceable to you.

  • (Score: 2) by krishnoid on Monday December 04 2017, @06:43PM

    by krishnoid (1156) on Monday December 04 2017, @06:43PM (#605188)

    Tattoos -- the cause of, and solution to, [soylentnews.org] recent issues in the news.

  • (Score: 2) by inertnet on Monday December 04 2017, @10:51PM

    by inertnet (4071) on Monday December 04 2017, @10:51PM (#605374) Journal

    My dead uncle had a "do not hesitate" tattoo, but in their haste the doctors read it as "do not resuscitate".

    (just kidding)

  • (Score: 2) by crafoo on Tuesday December 05 2017, @12:35AM

    by crafoo (6639) on Tuesday December 05 2017, @12:35AM (#605423)

    What an amazing and difficult profession. I can't imagine dealing with these kind of decisions daily.

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