Thursday, August 5, 2010

Mayo Study: Withdrawing LVAD Support Is Ethical

Mayo Study: Withdrawing LVAD Support Is Ethical - Health Blog - WSJ: High-tech medical devices can raise tricky ethical questions — just consider the left ventricular assist device (LVAD). The pricey device essentially takes over the function of the left ventricle, helping a heart to continue beating when it would otherwise fail. But what happens when patients become very, very sick and are essentially being kept alive by the LVAD? Is turning off the device more akin to euthanasia or taking someone off a ventilator?

LVADs make some clinicians uncomfortable for several reasons, they write — the device seems almost like a replacement part than outside assistance, for example. Researchers write, though, that withdrawing LVAD support isn’t the same as assisted suicide or euthanasia because there’s no “new pathology” introduced to cause death. Death, when it comes (all 14 patients died within a day of turning off the device), is due to the underlying heart failure, they write. So assuming patients or their representative know the consequences of deactivating the device, clinicians should honor their wishes.

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