Doctors treating the elderly patient knew of “a cautionary tale” published in 2012 in the Journal of General Internal Medicine. That paper told of a 59-year-old patient who had a “D.N.R.” tattoo across his chest but said he wanted lifesaving measures to be taken, in the event that he needed them.

When the patient was asked why he had the tattoo, he told doctors he had “lost a bet playing poker,” according to the report.

When outside of hospitals, Florida requires do-not-resuscitate orders to be printed on yellow paper and signed by a physician and the patient, or a surrogate. But inside the hospitals, doctors can talk to a patient, or the patient’s family and friends to determine what the end-of-life wishes are.