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Journal of Medical Ethics 2007;33:532-533; doi:10.1136/jme.2006.019000
Copyright © 2007 by the BMJ Publishing Group Ltd & Institute of Medical Ethics.
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ETHICS

Implantable devices

The ethics of implantable devices

Eugene B Wu

Correspondence to:
Dr E B Wu
Department of Medicine and Therapeutics, Prince of Wales Hospital, Ngan Shing Street, Shatin, Hong Kong; ebwu@netvigator.com Original version received 12 September 2006

Accepted for publication 22 September 2006

Both the doctor and the patient have rights to terminate an implantable cardioverter-defibrillator (ICD) device for reasons of futility or autonomy

The first 150 words of the full text of this article appear below.

Implantable devices have a long history in medicine with artificial hips being implanted since 1925, pacemakers since 1957, Starr-Edwards heart valve since 1961, artificial hearts since 1982 and ventricular assist devices since 1991. The ethics of deactivation or removal of these devices were not an issue until the use of implantable cardioverter defibrillator (ICD) device, as the ICD can produce considerable distress from defibrillation shocks in end-of-life patients. However, development of a clear ethics for ICD is critical as the massive technological advances in implantable heart failure devices will soon produce an epidemic of patients with implanted devices and end-of-life diseases. Should one turn off a biventricular pacer at the request of a patient who is having recurrent disabling heart failure? Should one turn off an AbioCor (AbioMed, Danvers, Massachusetts, USA) artificial heart in a patient who developed a severe disabling stroke from the device? Who has the . . . [Full text of this article]


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Copyright © 2007 by the BMJ Publishing Group Ltd & Institute of Medical Ethics.