England, Ruth, England, Tim and Coggon, John
The ethical and legal implications of deactivating an implantable cardioverter-defibrillator in a terminally ill cancer patient
Journal of Medical Ethics, 33, (9), . (doi:10.1136/jme.2006.017657).
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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
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