PMID: 16525225Mar 10, 2006Paper

End-of-life and other ethical issues related to pacemaker and defibrillator use in the elderly

The American Journal of Geriatric Cardiology
Lofty L Basta

Abstract

In the past decade, the rate of implantation of pacemakers and cardioverter-defibrillators in the elderly with cardiac impairment has soared. As patients near the end of life, interventions become more complicated and expensive, and less effective. In this context, "informed consent" requires consideration of issues different from those faced in more routine settings. Informed consent requires full disclosure, patient competence, and free exercise of will-but in practice, few patients or their families are in a position to make fully informed decisions about highly complex treatments at the end of life. Physicians continue to bear the responsibility of advising patients about sophisticated interventions or, alternatively, palliative care. Physician training, with its narrow focus on the treatment of disease with drugs and technology, has not prepared physicians to advise patients on issues arising from the availability of multiple interventions at the end of life. Professional societies can fill a gap by developing programs and materials to help physicians treat their dying patients in a high-technology era.

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Citations

Jul 27, 2011·Nature Reviews. Cardiology·Alexander M ClarkDavid R Thompson
Mar 8, 2007·The American Journal of Geriatric Cardiology·Hannah I Lipman
Apr 29, 2008·Pacing and Clinical Electrophysiology : PACE·Paul S MuellerDavid L Hayes
Sep 3, 2011·Journal of Palliative Medicine·Sandra N WhitlockJagmeet P Singh
Jun 4, 2014·Pacing and Clinical Electrophysiology : PACE·Abigale L OttenbergKeith M Swetz
Apr 1, 2009·American Heart Journal·Amy S KelleyMark S Lachs

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