One 70-year-old admitted to Jackson Memorial Hospital this year sparked an ethics debate when he arrived to the ER near death with the words “do not resuscitate” tattooed on his chest.

The statement was inked in bold, capital letters, the New York Times reported, and the man’s signature was tattooed beneath it.

Doctors administered some treatment to the man, who arrived unconscious and with a history of heart issues, lung disease and diabetes, but ultimately employed an ethics expert before taking any further steps.

“Here’s a guy who went through the trouble of getting a tattoo, which has the word ‘not’ underscored; he had his tattoo artist include his signature,” Kenneth Goodman, an ethics expert, told the Times. “You don’t go through that trouble, look at it every day in the mirror and actually not mean it.”

He ultimately advised the doctors to honor the man’s tattooed wishes, regardless of their skepticism that the permanent message could have been an impulsive decision in the man’s past. Without invasive treatment, the patient died in the hospital.

Read the full report here: