More on an Unconscious Patient with a DNR Tattoo

To the Editor: In response to the letter by Holt et al. (Nov. 30 issue) 1 describing a 70-year-old unconscious patient with a do-not-resuscitate (DNR) tattoo: we find it most troubling that the treating team originally planned on violating such prominently expressed wishes. Although any practitioner can wholeheartedly identify with discomfort in the face of uncertainty and understand the appeal of “not choosing an irreversible path when faced with uncertainty,” such reasoning potentially undermines all advance directives. To invoke the rationale of “well, he might have changed his mind or not have meant it” debases all such directives, because, of course, . . .