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Home Healthc Nurse. 2008 Jul-Aug;26(7):431-7. doi: 10.1097/01.NHH.0000326324.09466.97.

Deactivation of automatic implantable cardioverter-defibrillators in hospice and home care patients at the end of life.

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  • 1Department 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

Abstract

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.

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