You may have read about Indianan Maria Rodriguez. She is the 40-year-old nurse who has had the words "No Code," and the instructions "Pain and comfort only. Organ donor" tattooed on her stomach. In addition, her creative design includes a human heart with a circle and slash over it (the universal symbol for "no").

While many patients might agree with Ms. Rodriguez' sentiments, few are likely to go to the same trouble to make wishes known to paramedics and emergency room personnel. However, even if the question is purely academic we might consider whether Ms. Rodriguez has written a valid "living will" under Arizona law.

Like many states, Arizona has adopted laws recognizing several different types of "advance directives." Most commonly, they include living wills and durable powers of attorney for health care. Ms. Rodriguez' tattoo would not qualify as either, since it is not signed by her or properly witnessed.

Arizona also recognizes "pre-hospital medical care directives," a category of directives intended to deal with exactly Ms. Rodriguez' concern. By executing such a directive, a patient can direct that she would not want to be resuscitated by paramedics or emergency room personnel. These instruments, however, must be on orange paper and either letter-size or wallet-size. Ms. Rodriguez' tattoo does not qualify.

So can nurse Rodriguez' tattoo be dismissed as nothing more than a curiosity? No.

Even though it is not in the proper form to qualify as a formal advance directive under Arizona law, it is a potent and persuasive expression of her wishes. Since surrogate decision-makers (including agents under powers of attorney, guardians and family members) must take into consideration the wishes of the patient, the tattoo can and should be given considerable weight in gauging Ms. Rodriguez' desires. Ms. Rodriguez has taken an original and effective step toward ensuring that her wishes are honored. Few providers will forget her wishes.

White House Conference on Aging

For the past five weeks, Elder Law Issues has described the topics focused on by Arizona's Conference on Aging held in January. That conference was Arizonans' chance to help shape the agenda for the full White House Conference on Aging.

The national Conference will be held in Washington, D.C., the first week of May, 1995. Within the next few weeks, we will tell you more about the Arizona conference's recommendations and conclusions.
 
  

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