Inappropriate restrictions on life saving technology

When a patient dies it is of considerable consolation to relatives if they can be reassured that everything possible and appropriate was done. For many acute heart failure patients in the UK, this approach cannot be taken with honesty. This is because the NHS will not fund circulatory support equipment to treat cardiogenic shock in the majority of cardiac tertiary centres. Affected are 2 % of 40 000 cardiac surgical patients who fail to separate from cardiopulmonary bypass and around 5 % of 25000 myocardial infarction patients who progress to cardiogenic shock.1 2 These disparate groups suffer