The ethical and legal implications of deactivating an implantable cardioverter-defibrillator in a patient with terminal cancer

J Med Ethics. 2007 Sep;33(9):538-40. doi: 10.1136/jme.2006.017657.

Abstract

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.

MeSH terms

  • Defibrillators, Implantable / ethics*
  • Ethics, Clinical
  • Humans
  • Neoplasms*
  • Terminal Care / ethics*
  • Terminal Care / legislation & jurisprudence
  • Terminally Ill / legislation & jurisprudence
  • Withholding Treatment / ethics*