Why the study?
Is there a moral difference between deactivating an implantable cardioverter defibrillator and turning off a cardiac pacemaker?
Is there a moral difference between deactivating an implantable cardioverter defibrillator and turning off a cardiac pacemaker?
This ethical analysis argues for a moral distinction between deactivating ICDs and pacemakers, suggesting that deactivating pacemakers in dependent patients is generally impermissible and recommending a policy change for cardiac societies.
May inform device deactivation ethics; leaves open whether guidelines should adopt this distinction without broader consensus.
In this article, I argue that there is a moral difference between deactivating an implantable cardioverter defibrillator (ICD) and turning off a cardiac pacemaker (CP). It is, at least in most cases, morally permissible to deactivate an ICD. It is not, at least in most cases, morally permissible to turn off a pacemaker in a fully or significantly pacemaker-dependent patient. After describing the relevant medical technologies-pacemakers and ICDs-I continue with contrasting perspectives on the issue of deactivation from practitioners involved with these devices: physicians, nurses, and allied professionals. Next, I offer a few possible analyses of the situation, relying on recent work in medical ethics. Considerations of intention, responsibility, and replacement support my distinguishing between ICDs and CPs. I conclude by recommending a change in policy of one of the leading cardiac societies.
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Bryan Pilkington (2019) studied this question.
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