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After the decision had been taken, social workers also found a separate official document corroborating the tattoo's instruction.

The authors of the journal’s case study, wrote: “We initially decided not to honour the tattoo, invoking the principle of not choosing an irreversible path when faced with uncertainty.

He had learned the art from his father who learned it from his father who came from Egypt and brought with them the wooden hand-carved stamps that act as stencils for the religious designs of settings inspired from the bible such as the crucifixion, the acssention, the virgin Mary and baby Jesus, etc…

Pilgrims would stand in line waiting for their turn to be tattooed with either a cross or another design of their choice with the date as certification to their pilgrimage to the Holy Land and as a souvenir.

“This decision left us conflicted owing to the patient’s extraordinary effort to make his presumed advance directive known; therefore, an ethics consultation was requested.” Gregory Holt, the lead author of the new case study, said the biggest concern for him was whether it was legally the right decision.

“Florida has stringent rules on this,” he told Gizmodo.

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Doctors were left with an ethical dilemma after an unconscious patient was brought into their hospital with a "do not resuscitate" tattoo on his chest.

The 70-year-old man was taken by paramedics into the emergency room at Miami University Hospital with a high blood-alcohol level and without any identification, according to the New England Journal of Medicine.

Doctors discovered the patient’s tattoo with his signature beneath, but could not find a next of kin or any medical paper work for him.

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