The tattoo that presented the ultimate ethical dilemma for a team of ER doctors.

Emergency room doctors were faced with a heartwrenching ethical dilemma when a 70-year-old man was taken to the Florida hospital unresponsive.

The medical staff’s first instincts were to save the man’s life, but something they saw on the man’s bare chest gave them pause.

Tattooed on the unconscious patient’s chest were the words ‘Do not resuscitate’ above what looked like the man’s signature.

Normally, doctors are meant to uphold patient’s requests to not be resuscitated, but the manner of the request had them questioning the ethics of letting a man die.

The unnamed man had been taken to ER with a high blood alcohol level, and no identification – so they couldn’t contact his next of kin.

What would you do in this scenario?

(Image via New England Journal of Medicine.)

With no way of knowing if the tattoo was actually meant to be taken seriously, the doctors decided to revive the man.

This case was explored in the New England Journal of Medicine this week, which details how the doctors' decision to try to revive the man without contacting the hospital's ethics team was later criticised.

However, one of the doctors in question, Gregory Holt, put it like this: "We initially decided not to honour the tattoo, invoking the principle of not choosing an irreversible path when faced with uncertainty."

Holt added, "This decision left us conflicted owing to the patient’s extraordinary effort to make his presumed advance directive known; therefore, an ethics consultation was requested."

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Explored in the case study was the question of whether the tattoo could be considered a legal request. For instance, what if the patient was left to die and his family sued the hospital as a result?

Later, the ethics consultants advised them to honour the man's do not resuscitate request. And in the end, the hospital discovered the man also had an "out-of-hospital" DNR order with the Florida Department of Health.

The patient passed away later that night.

What would you do in this situation?