Which of the following does NOT qualify as a DNR/DNI?

• A. A tattoo indicating DNR
• B. An original written DNR order signed by physician and patient
• C. A verbal statement by a competent patient
• D. A copy of a DNR order

Answer: (A)

DNR/DNI directives must be formal medical orders that are clearly communicated, documented in the patient’s medical record, and recognized by the treating team. A tattoo indicating DNR is not a valid medical order because it is not an official, signed directive that can be authenticated, updated, or referenced in the chart. It lacks physician endorsement, dating, and the ability to be revised if the patient changes their mind or if circumstances change, and it can be misread or misunderstood in an emergency.

A written DNR order signed by the physician and patient provides a clear, durable directive that the entire care team can rely on. It is part of the legal medical record, includes dates and signatures, and can be updated as needed.

A verbal statement by a competent patient can also function as an enforceable directive, provided it is given with capacity, understood by the patient, and accurately documented in the chart, with follow-up to convert it into a written order as appropriate.

A copy of a DNR order is generally accepted as a portable form of the directive, especially when it mirrors the original, is readily accessible to staff, and is appropriately identified as a copy of the DNR. This supports consistency across settings and transfers.

So, the tattoo does not qualify because it fails to meet the criteria of an official, verifiable medical order, whereas the other forms represent proper ways in which a patient’s DNR/DNI preferences can be captured and followed.