PMID: 11343981May 10, 2001Paper

When withdrawal of life-sustaining care does more than allow death to take its course: the dilemma of left ventricular assist devices

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Katrina A Bramstedt, N S Wenger

Abstract

Left ventricular assist devices (LVADs) are a relatively new technology that is increasingly used to preserve cardiac function. These devices work by a mechanism that may complicate ethical decision-making for patients who subsequently lose decision-making capacity and are no longer considered transplant candidates. Using a clinical case from our medical center, we explored the complex ethical issues associated with the discontinuation of LVAD therapy by discussing how this device is distinct from the withdrawal of other treatments. While halting an implanted LVAD may permit a patient to die, the deactivated device itself may contribute to patient death due to the potential for blood backflow and pooling, as well as the disruption of heart contractility. Inadequate informed consent and failure to appoint a surrogate decision-maker in advance of the implant procedure resulted in a complex ethical dilemma for the patient's family and the medical team. Clinicians and families must consider the benefits and burdens of LVAD therapy as they do when considering removal of other life-sustaining treatment. The informed consent process associated with LVADs as bridging technology should include extensive consideration of the purpose of t...Continue Reading

References

Mar 1, 1992·The Annals of Thoracic Surgery·W S PhillipsE A Lefrak
May 1, 1997·The Annals of Thoracic Surgery·T P Powell, M C Oz
May 1, 1997·The National Medical Journal of India·J J Amy
Jan 16, 1998·Clinical Obstetrics and Gynecology·J C Gambone, R C Reiter
Feb 21, 1998·Intensive Care Medicine·G Melltorp, T Nilstun
Oct 20, 2001·Science and Engineering Ethics·Katrina A Bramstedt

❮ Previous
Next ❯

Citations

Oct 8, 2009·Journal of Palliative Medicine·Heather Ferris, Susan Hunt
Sep 1, 2005·Journal of Medical Ethics·S O Hansson
Aug 13, 2008·Philosophy, Ethics, and Humanities in Medicine : PEHM·Aaron G RizzieriJoan L McGregor
Oct 8, 2013·Journal of Pain and Symptom Management·Keith M SwetzMolly A Feely
Nov 6, 2007·AACN Advanced Critical Care·Debra Lynn-McHale Wiegand, Peggy G Kalowes
Sep 8, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sally BrushAbdallah G Kfoury
Jan 6, 2015·Pediatric Transplantation·Stefanie BenoitAngela Lorts
Mar 28, 2006·The Annals of Thoracic Surgery·Denise M Dudzinski
Jan 29, 2013·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·David FeldmanUNKNOWN International Society for Heart and Lung Transplantation
Mar 29, 2011·Hospital Practice·Keith M SwetzDaniel P Sulmasy
Jul 7, 2015·The American Journal of Bioethics : AJOB·Laura Guidry-Grimes, Nneka Sederstrom
May 22, 2016·Journal of Pain and Symptom Management·Joan T PankeHunter Groninger
Jun 13, 2002·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Katrina A Bramstedt
Dec 17, 2008·Current Opinion in Supportive and Palliative Care·Katrina A Bramstedt
Jun 1, 2017·Circulation·Jennifer L CookUNKNOWN American Heart Association Heart Failure and Transplantation Committee of the Council on Clinical Cardiology; Council on Car
Jan 22, 2008·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Katrina A Bramstedt
Aug 8, 2008·Current Opinion in Supportive and Palliative Care·James N KirkpatrickRalph Verdino
Jul 10, 2013·Theoretical Medicine and Bioethics·Edward Fried
Oct 19, 2002·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Katrina A Bramstedt, Daniel J Simeon
Mar 2, 2005·The American Journal of Hospice & Palliative Care·Jennifer M Ballentine
Apr 8, 2020·HEC Forum : an Interdisciplinary Journal on Hospitals' Ethical and Legal Issues·Sara Roggi, Mario Picozzi

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The Annals of Thoracic Surgery
Denise M Dudzinski
ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Katrina A Bramstedt
The Annals of Thoracic Surgery
T P Powell, M C Oz
© 2021 Meta ULC. All rights reserved