Tattooed DNR

ExpatMedic0

ExpatMedic0

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Do you recognize them if they have the legal signatures?

example of a "legal document" on patient below:

377874_10151164856306487_111286489_n.jpg
 
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I don't see a notary stamp on there :P No clue about the legal aspect but I assume that would be a very rare occurrence. If someone went through the trouble, discomfort, and cost to get a tattoo like the one above than I bet they are pretty serious about it.
 
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Considering we don't need an official dnr in the first place (where I work) as long as it seems like a resonable request we honour it.
 
We had a pharmacist (residency and fellowship trained; crazy smart guy) that worked in our University ED, who had DNR tattooed on his chest. He fully intended it to mean exactly what it said. I always wondered about the legality of honoring it.
 
I suppose it's as valid as other forms, but tattoos can blur and people change their minds. Wear and carry proper DNR notices.
 
I think that leaves no doubt as to his wishes.

I would honour it.

For the British :)
 
As Mycrofft mentioned... how do we know if he suddenly changes his mind? A bracelet can be removed. A DNR paper can be torn up. You can't quite say as much about a tattoo.
 
JPINFV said:
As Mycrofft mentioned... how do we know if he suddenly changes his mind? A bracelet can be removed. A DNR paper can be torn up. You can't quite say as much about a tattoo.
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Acceptable losses.
 
NJ State Regulations

As per our protocol (and by NJ state as I understand) the only form of acceptable DNR for BLS providers is an actual pre-hospital DNR that is complete and signed. We do not even honor a living will unless a pre-hospital DNR is attached.
 
Should I honor it? Probably. Can I honor it (without contacting medical control)? No.
 
Perfectly honourable, any reasonable request can be honoured including clearly described verbal directives.

Makes sense if you ask me.
 
I was taught that tattoo's don't count as a legal document and wont hold up in a court of law.
 
Revoking DNRs.

I am willing to bet that most people with a DNR do not revoke them.

I have never seen nor even heard of somebody doing it.

As for holding up in court, the standard has always been if it was reasonable to conclude that is what the person wanted.

I might be going out on a limb, but I am willing to say if a person has a DNR tattooed on their body, the burden of proof in my mind, has been met as to exactly what their wishes are.

I would have no problem explaining that to a judge or jury.

If such doubt persists, just call medical control.
 
Where I live, DNRs need to have a Dr's signature. In the case of a tattoo, the signature isn't actually the doctor's, but rather a close replica done by the tattoo artist. (Technically a forgery.) Wouldn't that cause some legal issues? Unless the doctor also moonlights in a tattoo parlour, that is.
 
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living-will-tattoo.jpg
 
dbo789 said:
Where I live, DNRs need to have a Dr's signature. In the case of a tattoo, the signature isn't actually the doctor's, but rather a close replica done by the tattoo artist. (Technically a forgery.) Wouldn't that cause some legal issues? Unless the doctor also moonlights in a tattoo parlour, that is.
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Before you get too technical, what are you going to do when you walk into a patient in arrest, doesn't have a DNR from a doctor and the whole family claims they were terminal and the patient expressed they don't want resuscitation?
 
Removed while I do some more research.
 
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When in doubt, start resuscitation and call the hospital. They can direct you whether or not to continue, and they will actually listen to the family's wishes. If an EMS crew is dense enough to try and have a family charged with interfere on a non suspicious cardiac arrest I hope the family turns around and goes after the crew for assault.
 
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First lets remember this is a Living Will and NOT a DNR or POLST. Also remember that this has to do with life support and not resucitation.

A tattoo is not to be considered a legal document. Also, a Living Will must follow the same standards as a will for it to be legally enforceable. That said, people do tattoo medical information on them all the time.

Relying solely on the tattoo would likely get you into legal trouble. Most jurisdictions have rules regarding living wills and how they are to be stored.

A British woman had a DNR tattooed onto her chest. The British courts have said it is not enforceable or valid. While US and British are two entirely different systems, I would assume that any court would look for established legal opinions even if that meant looking to other countries - which is actually a quite common legal practice. Based on this I would assume that legal precedent would be set that a Tattooed DNR or Living Will is not valid. What happens if the patient in their distress wishes to live and revoke the directive? Current standard states a patient can destroy their DNR or Living Will up to the time of need. Also, family has the right to verbally revoke or destroy the directive.

Until this actually comes to happen, I can't see any correct answer. Ultimately its going to be a situation dependent decision. I would hope that any provider would be calling medical control as a CYA.

http://firelawblog.com/2011/09/dnr-tattoos-are-you-kidding-me/
http://www.washingtonlawhelp.org/documents/1543019501EN.pdf?stateabbrev=/wa/

In my opinion it is not valid and efforts will be made to revive the patient.
 
How many DNR patient contacts end up as court cases? Has anyone ever heard of an EMS crew being sued by a patient's family for following the wishes of a patient that were written out (not necessarily properly) prior to death?

I'm in my phone so my own research is poor.
 
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