The question was asked the other day in relation to a patron approaching staff at an aquatic centre to show them the new tattoo they got.  A 'Do Not Resuscitate' (DNR) tattoo was permanently inked to their body and hence the patron wanting it known to staff at the time that they did not want to be resuscitated if ever the time arose that they may require CPR.  The questions were asked. What are the implications if staff did resuscitate the person who has previously made it known they did not wish to be resuscitated?  What is our duty of care and responsibilities of performing CPR on a patron knowing previously they do not wish to be revived?

With this in mind we endevoured to investigate and spoke with the medical consultant for Royal Life Saving Society Australia. It turns out that DNR tattoo's do not hold any legal status here in Australia and I suppose it makes sense to ignore the tattoo and follow your training.  Whilst a tattoo can convey their thoughts and requests at the point of time of getting the tattoo, it is unfortunately forever there, even if they have changed their mind.  This applies to DNR letters or requests to aquatic staff and facilities.

As first aiders and first responders to incidents we have always been trained to gain consent or if unconscious consent is implied.  We do not know in most cases why a person got a DNR tattoo put on them, it could have been a legitament reason at the time, or a silly idea whilst under the influence.

With this in mind we should never assume we know what the person is thinking at the time the person is requiring immediate care and perform CPR if the patient requires it.  

Whilst it is rare that we may come across this it is important to know that as lifeguards we do not have the rights to determine if someone should receive CPR or not based on a tattoo or request and should always follow the protocols of Pool Lifeguard and First Aid Training, if unconscious assume consent.