Bureaucratic Hurdle: Turning Off a Defibrillator

Specialists say that a failing heart often begins to beat in the same type of wildly erratic rhythm that a defibrillator is programmed to recognize and intercept with a jolt. And though doctors and patients routinely discuss end-of-life issues like withdrawing medications and resuscitation attempts, studies suggest that what to do about a defibrillator rarely comes up…

A doctor friend told Ms. Filak about horrible scenes he had witnessed in which a defibrillator had shocked a dying patient, causing pain and terrifying family members gathered at the bedside. But when Ms. Filak tried to get the device deactivated, she was bounced around for weeks by her father’s doctors, including his cardiologist, she said…

Only 10 percent of some 400 hospices that responded to a survey had formal policies in place to discuss defibrillator deactivation. About 60 percent of patients in the hospices with defibrillators still had the shocking function active, the survey found.

Full article on the challenges of turning off a heart defibrillator at life’s end.

Comments (7)

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  1. Linda Gorman says:

    Headline for article: “Lifesaving Devices Can Cause Havoc at Life’s End.” Yep, another knock on lifesaving devices.

    The article mostly discusses the fact that a daughter couldn’t get physicians to shut off her father’s defibrillator when he was given two to six months to live. His cardiologist did shut it off when he finally became comatose. Whether the father, the actual patient, had an opinion is not discussed.

    The article does note that “some” dying patients, when asked, have chosen to keep the device active.

    As usual, the point of the article is that we need guidelines because while people’s lives may be extended by the defibrillator implants and their heart problems “may not kill them, they will eventually succumb, be it due to accidents, illnesses like cancer or simply old age.”

    Does the author really mean to imply that since people are dying anyway it doesn’t matter whether they have access to lifesaving technology or not?

  2. Ken says:

    Linda, I think there is a different point. It’s that the health care system often functons like a bureaucracy, not much better than the Department of Motor Vehicles.

  3. Vicki says:

    I agree with Ken. The health care system does resemble the DMV. At least most of the time.

  4. Devon Herrick says:

    This article highlights how complicated end-of-life care decision can become. Patients and their families have differing ideas of how much care is too much care; and which care is too much.

    Telling caregivers “save me if I start to die of condition ‘A’ but not if I start to die of ‘B’ complicates the process.”

  5. Joe S. says:

    Also, it is a bureaucracy that is going to get a whole lot more bureaucratic under Obamacare.

  6. Virginia says:

    If it were really a market economy, the user of the device would be able to turn it on and off at will (probably by some mechanism which has several safety checks to ensure that it is not accidentally deactivated).

  7. artk says:

    Virginia sez: “user of the device would be able to turn it on and off at will”

    Even better, your wife can turn it on and off at will.