Tattooed DNR
- Thread starter ExpatMedic0
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This is not true everywhere. In my home state only the person who signed a DNR can revoke it.
The family was purposely cut out of that.
As for Tattoos as a legal document. I doubt you will find any country in the world, except perhaps prisons in Russia, where a tattoo is considered a legal document.
However, in most civilized countries, including the US, a patient who makes their wishes known, whether as a living will, DNR, or other document, should(as it is taught in Western medical ethics classes worldwide) , and likely will, have their request honored.
If I recall correctly, this originated with a case of a lady (from San Fran) who hand wrote a document and was unaware of any formal process back in the 1980s.
I will pull out the official "how would you want to be treated?"
Now I do not doubt that US EMS providers are not permitted to make the decision on whether or not a person should be resuscitated based on their wishes, but a doctor can.
Rather than a futile resuscitation or prolonged life support and generating a bill, it is probably a med control phone call that should be made.
It is a lot harder to take somebody off life support than it is to not start it.
You might also save a family member from the grief of having to make the decision to pull the plug.
Of course if they are known, assuring the family during this time of stress it is the desire of the patient and their wishes should be honored.
All of the families I have personally seen who wanted resuscitation attempted on a DNR were just under the anxiety of wanting to do something or not knowing what else to do. (Which is probably why they called 911 in the first place.)
You would be surprised by just how many laws and rules can be completely disregarded by a physician.
Not because they are above the law, but because all kinds of exceptions and caviats are afforded to them by virtue of their role in society.
Consider a doctor signing an involuntary commit order. By her judgement of you not being mentally capable to make a rational decision, your rights to all self determination, contact, representation, and even due process can all be forfeit.
You won't even get a phone call.
mycrofft
Still crazy but elsewhere
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Deucedly inconvenient, that!
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I am not sure (where's our ems lawyer?) but any utterance, while still of sane mind and not under duress of another, regarding your own care and demise, if otherwise legal and not forcing another to act illegally, is binding. Hence, "Wait for them to pass out" is invalid. But you can say the pt was ignorant of alternatives or in such pain they would do anything (hence in duress or temporarily insane).
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mycrofft
Still crazy but elsewhere
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"If I recall correctly, this originated with a case of a lady (from San Fran) who hand wrote a document and was unaware of any formal process back in the 1980s."
Called a holographic will, and held valid if witnessed when possible.
Called a holographic will, and held valid if witnessed when possible.
mycrofft
Still crazy but elsewhere
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Do you recognize them if they have the legal signatures?
example of a "legal document" on patient below:
Nice skin donor site....
TMEEMT
Forum Ride Along
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Oh wow...:blink:
each state is different when it comes to dnr and living will. from what i remember from my law school is that tattoo is not valid document. there is more problems honoring the tattoo DNR families can sue from left to right. until the congress or the supreme court issue the ruling. its not recommended.
Bullets
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Id honor it, if i can honor a patients family on scene stating they do not wish for efforts to be in place i have honored them. A lot has to go into my decision but i dont think it would be invalid just because its a tattoo
Shishkabob
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Nope, we don't recognize it without further info. Infact, we even had a story on such where a news agency asked our PIO about it.
And I quote
Sure, it can be argued that their desires are obvious... but then again, a drunken party night, a doctor with an odd sense of humor, etc etc.
And I quote
Sure, it can be argued that their desires are obvious... but then again, a drunken party night, a doctor with an odd sense of humor, etc etc.
Let me put it simply by law it is not legally binding Therefore it will be invalid.
I am not knowledgable enough to argue law with a lawyer, but from my medical school days, we were specificall instructed that as far as ethics and self determination were concerned, if a patient's wishes could clearly be determined, they were to be honored, no matter the form of the indication.
I see this as no different than a family member saying "my mother/father/whoever, does not want you to do all of that."
I do not contest it is not a legal document. I never said it was. Only that it meets the ethical criteria I work under for making wishes known.
If they are going to sue, let them sue, they will find one reason or another to anyway.
Bullets
Forum Knucklehead
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Basically this. Just because the person is dead does not mean my role has ended. Until i make my assessment they are still my patient and i am always going to act in the best interests of a patient. If the patient is at home, has a medical history like 90% of my cardiac arrests do and the family states that they nor the patient wished for the type of interventions we (the BLS/ALS) team will perform how would i be ethical in doing so.
Clearly the family is in some distress but it does not take long to explain the basics of a resuscitation. How is intubating, compressing, electrocuting and cannulating/drilling into an old person, strapping them to a board and going to the hospital ethical? For maybe a few extra months that they will spend on a machine to pump their heart and breathe? God knows we nuked their brain with epinephrine and will die a vegetable
instead lets honor the family and most likely the patients wishes, console them for a few moments after explaining their options extend our condolences and let them be with their loved ones
Clearly im not talking about people under 50 with no history who keeled over on the toilet, these are the kinds that have hospital beds in their house
mycrofft
Still crazy but elsewhere
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Oh, God, wake up with a hangover AND a DNR across your chest!
This varies from jurisdiction to jurisdiction, especially in the areas of DNRs. A lot of other nations don't put as much value on personal liberty as the US. In many cases a professional may be able to 'infer' the person's wishes, but if the T's aren't crossed and the I's not dotted, they're getting resuscitated.
Quite honestly, if it is THAT important to the patient, it should be worth the time to get it perfect anyway.
Aidey
Community Leader Emeritus
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I actually think the US is worse than other countries. Unless you have an iron clad state approved DNR you're getting resuscitated whether you like it or not. Any family member can over rule your wishes at any time.
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Perhaps. I can't claim to be knowledgeable about the laws of a jurisdiction I don't reside or work in. I was just directly addressing Vene's point. There are still significant jurisdictional differences though. For example, family doesn't get input here unless the DNR specifically provides that power to someone else. And quite honestly, if the DNR was valid, we wouldn't be having this conversation in the first place.
On the flip side, if the DNR is ironclad, that's the ball game. The family member can begin CPR on their own, but we're not playing. (Unless, of course, the DNR also give decision making power over this issue to the person in question.)
There is likely a different line between how the law applies to Doctors and EMS professionals too, although in an emergent, unexpected situation I would hope the decisions to be very similar.
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You mean an attempt at resuscitation will be made
Success is not assured.
Haha, indeed.
Unfortunately, not everyone can be God like Vene....
