Do Not Resuscitate: a Follow-Up to Implied Consent

In one of my last couple of blog posts, I discussed the topic of implied consent in the context of DUIs. Essentially, if you deny a breathalyzer test, you may not be charged with a DUI, but your driver’s license can be suspended for 6-months and you may be fined $500. However, implied consent refers to more than just potential cases of DUIs. In many cases, especially when emergency health services are called upon, this type of consent is relevant. If the patient is unconscious or unresponsive, medical professionals will typically take all measures to ensure the patient survives with or without his or her consent.

In class last week, Professor McCoy sent as all a link to an article titled An Unconscious Patient with a DNR Tattoo” a day or so after I submitted my blog post about implied consent. I related this article to my blog post immediately due to the similarity between the patients and suspects–neither consented to the tests or procedures. However, while the implied consent in the DUI situation serves to protect harmless drivers who aren’t under the influence of alcohol or drugs, the implied consent in the second situation is for the sake of ethics.

The patient in this article remains nameless. His chest exhibited a tattoo reading “Do not resuscitate”, more familiarly referred to as DNR. He presented no identification and no family contacts, further exacerbating the confusion of the situation. Paramedics didn’t honor the command on the tattoo, and the patient passed away overnight. However, the ethics consultants disagree with the choice of the paramedics, and believe the tattoo should have been honored.

“They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients’ best interests.” The ethics consultants suggest that the law can often cause confusion about when patients’ desires should be taken into account, which causes even more issues with consent.

Another quote from this article states, “This patient’s tattooed DNR request produced more confusion than clarity, given concerns about its legality and likely unfounded beliefs that tattoos might represent permanent reminders of regretted decisions made while the person was intoxicated.” This is clearly another issue to be taken into account. Oftentimes, people get tattoos of poetry or words that they don’t actually mean to be taken literally, but rather for for an ironic effect. There’s always a chance that “Do not resuscitate” could be lyrics from a song or the result of drunken escapades.

This article begs the questions: to what extent should medical professionals have the right to make life-altering decisions for their patients? And is their current system effective at making these choices?

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