AUGUSTA — A proposal before the Legislature would allow Mainers who don’t want emergency medical care to get a “Do Not Resuscitate” tattoo on their chests to indicate their wishes.
The measure would prohibit “emergency medical treatment providers from starting resuscitation on a person when an order not to resuscitate is presented in the form of an indelible mark on the person’s chest.”
The Judiciary Committee plans Wednesday to discuss the proposal.
Rep. Beth Turner, R-Burlington, said she introduced the bill after a constituent told her she didn’t want anyone to resuscitate her if she stopped breathing — and had gone so far as to get a tattoo to make her wishes clear to anyone.
That constituent, Cathy Hazelton, testified that she’s been involved in emergency medicine for 57 years and often found herself doing CPR on people “who I knew did not want any lifesaving measures” but didn’t have any written instructions available.
Since Hazelton can’t always carry her own paperwork, she took it upon herself “to have my DNR status tattooed on my chest” so everyone will know what she wants.
Turner pointed out that people who don’t want treatment if they stop breathing often don’t have documents on them and that even jewelry stating their wishes has a way of getting lost in an accident.
She said the intent of her legislation “is to make certain that those who wish not to be resuscitated have an alternative means of making that clear, as Mrs. Hazelton’s tattoo is not likely to be legally accepted” the way the law reads now. Including the right to express a DNR wish with a tattoo would allow the medical community to recognize its validity, Turner said.
Andrew MacLean, deputy executive vice president and general counsel of the Maine Medical Association, told legislators at a recent hearing that his organization and the Maine chapter of the American College of Emergency Physicians “have substantial concern about this proposal” to revise the protocol for emergency medical services.
He said EMS personnel “must react very quickly in the field and, in order to recognize, interpret and properly respond to a do-not-resuscitate or DNR order, it must be in a format that is commonly recognized among EMS personnel, such as a MedicAlert bracelet” or the advance directives commonly used by patients.
MacLean said noticing a tattoo, which would be obscured by clothing, would pose a problem and it “could be very difficult for EMS personnel to determine” its validity since it might not include any dates, signature or indication that a patient had received counseling from a physician about what a DNR order entails.
Moreover, he asked, “How would EMS personnel know if the patient had revoked a tattoo representation of a DNR order?”
The Maine Ambulance Association is also raising questions about the proposal, including its failure to define what constitutes an “indelible mark.”
“Does this include handwritten markers?” the association asked. “We understand the good intentions of this legislation, but this bill raises a number of serious questions for EMS providers.”
But Rep. Sheldon Hanington, R-Lincoln, said that “in a time of crisis an EMT will not have time to look in your wallet” for a DNR card and a bracelet indicating the wish “may have inadvertently gone missing.”
“Like all other health and medical decisions, your decision to be resuscitated in an emergency situation should be based on personal values and preferences,” he said. “In a time when you can no longer speak for yourself, these DNRs speak on your behalf.”
“Tattoos, unlike cards or bracelets, are permanent. Tattoos cannot be misplaced nor can they be removed easily,” Hanington said.
He told colleagues that by supporting the measure, they are backing “an individual’s right to choose” and “their right to make their own health decisions.”
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