Différance and the (Potentially Preventable) Death of the “Do Not Resuscitate” Author

The use of Do Not Resuscitate (DNR) tattoos as expressions of end-of-life directives presents medical professionals with significant ethical and interpretive uncertainty. Although DNR tattoos may appear to provide clear evidence of a person’s wishes, disagreement remains regarding whether they should be treated as authoritative when a patient is unconscious and unable to elaborate. This article addresses this ambiguity through Roland Barthes’ The Death of the Author and Jacques Derrida’s concept of différance. These ideas have significant practical implications because emergency department personnel have limited time to determine how to respond. This requires the DNR tattoo situation to be thoroughly considered before entering an emotionally charged clinical environment, where heightened emotions may inhibit thoughtful decision-making. Our analysis supports the view that DNR tattoos are an ethically unreliable basis for medical decision-making and should not be regarded as authoritative expressions of patient autonomy in emergency clinical practice. Instead, we align with those who argue that the principle of non-maleficence should be honoured to initiate lifesaving treatment until a legal DNR advance directive is located.