Abstract: Patients who wish to refuse resuscitation at the end of life face hurdles in having their wishes respected by health care providers. Some opt to tattoo phrases such as “DNR” or “No Code”, etc. onto easily visible parts of their body so as to ensure that they will not receive unwanted treatment (Smith and Lo 2012). It is unclear, however, what the legal status of bodily engravings is and whether following such directions constitutes good policy. I will begin by providing an overview of the legal landscape of DNR tattoos by examining informed consent and advance directive statutes. I will compare the utility of DNR tattoos with DNR bracelets or POLST forms. I argue that DNR tattoos are relevantly analogous to self-written wills and other indications of patient wishes. Tattoos often reflect deeply held values or memories, and DNR tattoos can indicate patient desperation at a lack of effective alternatives. In either case, respecting and following the message that a tattoo conveys is required as a part of respect for patient autonomy. As such, there is an ethical imperative to withhold CPR when a health care provider sees a tattoo refusing it and there is no indication the patient has had a change of mind. I will close by examining how the rise of DNR tattoos indicates that the medical system must work to further improve patient trust in medicine, especially at the end of life.
Learning Objectives:
After participating in this conference, attendees should be able to:
Understand the motivations of patients seeking DNR tattoos
Understand the legal landscape surrounding DNR tattoos
Apply accepted ethical standards to the circumstances of patients with DNR tattoos
