Ethics of Deactivating Implantable Devices

Turning off heart devices near life's end stirs ethical, legal debates

Kevin B. O'Reilly
American Medical News
November 24, 2010

Only 12% of lawyers thought turning off a pacemaker amounted to physician-assisted suicide, compared with 24% of patients. One in 10 doctors thought deactivating a defibrillator was akin to assisted suicide, said the study in Mayo Clinic Proceedings.

Link: Ethics of Deactivating Implantable Devices, Glenn McGee, PhD, John B. Francis Chair in Bioethics, The Bioethics Channel, 17 minutes 56 seconds

Do we need to round on J.B. today?

Rosemary Flanigan, PhD

Since I've decided to keep my two ethics brown bag sessions each month, I'm always looking for material--and today's session is using the case in the recent Hastings Center REPORT, that of a 32 year old man, shot in the head and abdomen during a robbery he witnessed, and now, several months later, still in the intensive care unit cared for by the trauma team.

He needs a ventilator, nurses to suction his secretions, neurology consultants to assess his status, etc., etc. And lately, members of the trauma team have asked the nurses, "Do we need to round on J.B. today?"

I hope to get the groups to see this as a moral issue--certainly, his case brings with it moral distress not just for the trauma team, but for the nurses, and even for his mother. And I shall ask, "Where does help come from?"

Am I wrong to think that nursing home staff deal with chronic care more ably than hospital staff? What makes the difference? Is this an ethics COMMITTEE issue? (In the case, his attending physician asks for a consult because of what he is hearing and seeing. Is this a futile gesture?)

ALL insights are appreciated. THANKS.