PT  - JOURNAL ARTICLE
AU  - England, Ruth
AU  - England, Tim
AU  - Coggon, John
TI  - The ethical and legal implications of deactivating an implantable cardioverter-defibrillator in a patient with terminal cancer
AID  - 10.1136/jme.2006.017657
DP  - 2007 Sep 01
TA  - Journal of Medical Ethics
PG  - 538--540
VI  - 33
IP  - 9
4099  - http://jme.bmj.com/content/33/9/538.short
4100  - http://jme.bmj.com/content/33/9/538.full
SO  - J Med Ethics2007 Sep 01; 33
AB  - In this paper, the ethical and legal issues raised by the deactivation of implantable cardioverter-defibrillators (ICDs) in patients with terminal cancer is considered. It is argued that the ICD cannot be well described either as a treatment or as a non-treatment option, and thus raises complex questions regarding how rules governing deactivation should be framed. A new category called “integral devices” is proposed. Integral devices require their own special rules, reflecting their position as a “halfway house” between a form of treatment and a part of the body. The practical problems faced by doctors working in palliative medicine with regard to the deactivation of ICDs are also considered.