Ethical and legal views of physicians regarding deactivation of cardiac implantable electrical devices: a quantitative assessment.

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Daniel B KramerWilliam H Maisel

Abstract

Despite the high prevalence of pacemakers and implantable cardioverter-defibrillators, little is known about physicians' views surrounding the ethical and legal aspects of managing these devices at the end of life. The purpose of this study was to identify physicians' experiences and views surrounding the ethical and legal aspects of managing cardiac devices at the end of life. Survey questions were administered to internal medicine physicians and subspecialists at a tertiary care center. Physicians were surveyed about their clinical experience, legal knowledge, and ethical beliefs relating to the withdrawal of PM and ICD therapy in comparison to other life-sustaining therapies. Responses were obtained from 185 physicians. Compared to withdrawal of PMs and ICDs, physicians more often reported having participated in the withdrawal or removal of mechanical ventilation (86.1% vs 33.9%, P <.0001), dialysis (60.6% vs 33.9%, P <.001), and feeding tubes (73.8% vs 33.9%, P <.0001). Physicians were consistently less comfortable discussing cessation of PMs and ICDs compared to other life-sustaining therapies (P <.005). Only 65% of physicians correctly identified the legal status of euthanasia in the United States, and 20% accurately repo...Continue Reading

References

Sep 1, 1991·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·C J FoulksA H Moss
Jun 1, 1991·Journal of the American Society of Nephrology : JASN·J L HolleyA H Moss
Feb 1, 1995·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·E PerryR Swartz
Jan 1, 1993·American Journal of Public Health·M Z SolomonS Donnelley
Oct 1, 1996·Journal of the American Society of Nephrology : JASN·E PerryC Buck
Mar 4, 2000·JAMA : the Journal of the American Medical Association·E D Pellegrino
Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
Jun 14, 2002·The New England Journal of Medicine·Gervasio A LamasUNKNOWN Mode Selection Trial in Sinus-Node Dysfunction
Jan 16, 2003·Intensive Care Medicine·Daren K HeylandChristopher J O'Callaghan
Mar 18, 2003·Journal of Critical Care·Daren K HeylandAmiram Gafni
May 21, 2004·The New England Journal of Medicine·Michael R BristowUNKNOWN Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators
Mar 9, 2005·The New England Journal of Medicine·John G F ClelandUNKNOWN Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators
Mar 24, 2005·The New England Journal of Medicine·George J Annas
Mar 24, 2005·The New England Journal of Medicine·Timothy E Quill
Apr 20, 2005·Annals of Internal Medicine·Jeffrey T Berger
Jan 13, 2006·Patient Education and Counseling·Dena J Schulman-GreenSidney T Bogardus
Mar 15, 2006·Archives of Internal Medicine·Neil J FarberE Gil Boyer
Jan 10, 2008·Journal of General Internal Medicine·Daniel P Sulmasy
Apr 29, 2008·Pacing and Clinical Electrophysiology : PACE·Paul S MuellerDavid L Hayes
Jun 14, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Bruce L WilkoffUNKNOWN Heart Failure Society of America
Apr 1, 2009·American Heart Journal·Amy S KelleyMark S Lachs
May 18, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Rachel LampertUNKNOWN Hospice and Palliative Nurses Association

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Citations

Aug 2, 2011·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Daniel B KramerPaul S Mueller
Aug 24, 2011·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Paul S MuellerBarbara A Koenig
Jun 23, 2011·Current Treatment Options in Cardiovascular Medicine·Blair P Grubb, Beverly Karabin
Jan 27, 2012·The New England Journal of Medicine·Daniel B KramerPeter J Zimetbaum
Sep 22, 2011·Circulation. Cardiovascular Quality and Outcomes·Daniel B KramerUsha B Tedrow
Nov 5, 2013·Future Cardiology·Stephen J PettitRoy S Gardner
Jan 20, 2015·International Journal of Cardiology·Annika Kinch WesterdahlViveka Frykman
Dec 12, 2012·Progress in Cardiovascular Diseases·Daniel B KramerDan W Brock
Sep 8, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Paul S Mueller
Feb 4, 2014·Pacing and Clinical Electrophysiology : PACE·Anna StrömbergIngela Thylén
Feb 17, 2015·Pacing and Clinical Electrophysiology : PACE·Margaret DaeschlerJames N Kirkpatrick
May 24, 2015·Herzschrittmachertherapie & Elektrophysiologie·D PfeifferN Klein
Jun 15, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Roland TilzNikolaos Dagres
Jul 2, 2016·The American Journal of Bioethics : AJOB·Dena S Davis
Dec 25, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Eleni S NakouPanos E Vardas
Dec 5, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Margaret DaeschlerJames N Kirkpatrick
Feb 16, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Annika Kinch Westerdahl, Viveka Frykman
Jan 6, 2012·The American Journal of Hospice & Palliative Care·Balraj Singh, Jasmeet Singh
Jun 4, 2015·Circulation. Cardiovascular Quality and Outcomes·Daniel B KramerSusan L Mitchell
May 3, 2019·Herzschrittmachertherapie & Elektrophysiologie·Jochen Dutzmann, Carsten W Israel
Oct 26, 2011·Current Opinion in Supportive and Palliative Care·Esther Waterhouse, Fawad Ahmad
Oct 11, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Emmanuel N SimantirakisPanos E Vardas
Dec 13, 2019·Clinical Cardiology·Mark F Sullivan, James N Kirkpatrick
Aug 1, 2018·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Mark HermanYelizaveta Vayl
Oct 11, 2019·Journal of Palliative Medicine·Shunichi NakagawaCraig D Blinderman
Jul 27, 2011·Nature Reviews. Cardiology·Alexander M ClarkDavid R Thompson
Apr 8, 2020·HEC Forum : an Interdisciplinary Journal on Hospitals' Ethical and Legal Issues·Sara Roggi, Mario Picozzi
Nov 16, 2012·Deutsches Ärzteblatt International·Jörg CarlssonDietrich Pfeiffer
Jan 23, 2019·The American Journal of the Medical Sciences·Rohan KheraMelanie S Sulistio
Apr 29, 2019··Liga LavrinovicaMikael B. Skov

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