DNR Tattoos: A Cautionary Tale
Clinical Practice: Clinical Images
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KeywordsPublic Health Hypertension Diabetes Mellitus Internal Medicine Medical Record
A 59-year-old man with diabetes mellitus, peripheral vascular disease, hypertension and dyslipidemia was admitted to the hospital for a below-the-knee amputation due to chronic non-healing wounds of his lower extremity. Physical examination revealed a “D.N.R.” tattoo on his chest (Fig. 1). Upon reviewing his code status, he indicated that he would want resuscitative efforts initiated in the event of a cardiac or respiratory arrest. However, he did not want prolonged attempts at resuscitation. When asked why his tattoo conflicted with his wishes to be resuscitated, he explained that he had lost a bet playing poker with fellow ancillary hospital staffers while inebriated in his younger years; the loser had to tattoo “D.N.R.” across his chest. His code status was subsequently documented correctly in his medical record with further explanation of his wishes. Despite his comorbidities, he was relatively active in his outside life and was medically stable during his time in the hospital. It was suggested that he consider tattoo removal to circumvent future confusion about his code status. He stated he did not think anyone would take his tattoo seriously and declined tattoo removal.
© Society of General Internal Medicine 2012