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>Ultimately, the tattoo “produced more confusion than clarity,” the doctors said in the letter.

I'm not sure how a giant tattoo with the word "not" underlined and a facsimile of this man's signature could cause any sort of confusion, it seems really straightforward.

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According to the article, a proper discussion needs to happen between the patient and a physician, to make sure what the patient's wishes are. An example I can think of, is I may not want to live the rest of my life with tubes coming out of me, so I may be inclined towards a DNR. However, a DNR could also cover not using the Heimlich maneuver if I happen to be choking on a bite of apple while still in the hospital. In that case, yes, please resuscitate me.

There was a case in 2012 where someone had a DNR tattoo as a joke after losing in poker. It was published in a medical journal:

https://link.springer.com/article/10.1007%2Fs11606-012-2059-...

The doctors in this case were reportedly aware of this previous precedent: http://wapo.st/2AjHdLb

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