Why the study?
What are the ethical and legal implications of deactivating an implantable cardioverter-defibrillator in patients with terminal cancer?
What are the ethical and legal implications of deactivating an implantable cardioverter-defibrillator in patients with terminal cancer?
This paper provides an ethical and legal framework for managing ICD deactivation in terminally ill patients by proposing the concept of 'integral devices'.
May inform ethical approaches to ICD deactivation in palliative care; leaves open empirical validation of the integral device framework.
In this paper, the ethical and legal issues raised by the deactivation of implantable cardioverter-defibrillators (ICDs) in patients with terminal cancer is considered. It is argued that the ICD cannot be well described either as a treatment or as a non-treatment option, and thus raises complex questions regarding how rules governing deactivation should be framed. A new category called "integral devices" is proposed. Integral devices require their own special rules, reflecting their position as a "halfway house" between a form of treatment and a part of the body. The practical problems faced by doctors working in palliative medicine with regard to the deactivation of ICDs are also considered.
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England et al. (2007) studied this question.