Thursday, March 11, 2010

Turning Off Implanted Defibrillators

End-of-life issues with implantable cardiac defibrillators (ICDs) and the need (or not) for deactivation policies is being discussed at the palliative medicine blog, Pallimed.

Shoot on over and lend your $0.02 to the discussion.

-Wes

2 comments:

Lisa Emrich said...

I sat in a hospital room with a man whose pacemaker was the only thing keeping him going. It extended the process quite a bit but there was nothing hospice could do about it.

His heart beat was very weak and his body had grown cold while he was taking maybe 1-2 breaths per minute.

The point at which I was the person who noticed it had been about 3 minutes since his last breath, it was confirmed that his body had finally stopped.

I believe that this was very hard on his son who had been sitting vigil. I hope that it wasn't uncomfortable for this man.

The nurses had asked if he could be waiting for somebody, maybe a family member, before passing. I believe that the 'somebody' was likely my mother. She and I flew there half-way across the country the morning of the day he died and spent several hours with he and his son.

Before this situation I had never thought about how a pacemaker might unnecessarily prolong someone's death. If only his had a way to be deactivated, they would have done it.

But then again, if it had, I would not have been the person in the room who noticed he had finally died while we were laughing and telling stories. I'm kinda glad that he died while his son was laughing rather crying, although I don't know if it truly matters.

Lyle Fettig, MD said...

Dr. Wes-

Thanks for the reference to our blog and your comments there.

For more on palliative care in cardiology, see these posts.

Lyle