Deactivation of automatic implantable cardioverter-defibrillators in hospice and home care patients at the end of life.
For patients at the end of life, active automatic implantable cardioverter-defibrillators (AICDs) may no longer achieve the treatment goals present at the time of implantation. It is possible to deactivate AICDs in patients with terminal and life-limiting diagnoses, thereby preventing the pain and distress of nontherapeutic discharge. This article presents a moral argument for the right of such patients to have their AICDs deactivated. It then explains that hospice and home care agencies have an obligation to address AICD deactivation at a policy level and offers recommendations for doing so.
Kirk
Timothy W
TW
Department of History and Philosphy, City University of New York-York College, 94-20 Guy R. Brewer Blvd., Jamaica, NY 11451, USA. timothy.kirk@york.cuny.edu
D000368:Aged; D017147:Defibrillators, Implantable; D004868:Equipment Failure; D006699:Home Care Services / Q000941:ethics*; D017051:Hospice Care / Q000941:ethics* / Q000523:psychology; D006801:Humans; D008297:Male; D009014:Morals; D028701:Patient Rights / Q000941:ethics*; D013727:Terminal Care / Q000941:ethics* / Q000523:psychology; D028761:Withholding Treatment / Q000941:ethics*