Deactivating Implanted Cardiac Devices: Euthanasia or the Withdrawal of Treatment?
Indiana University - Robert H. McKinney School of Law
March 30, 2013
39 William Mitchell Law Review 1287 (2013)
This response to Prof. Lars Noah addresses a thorny question in bioethics and law — does the deactivation of a pacemaker or other implanted cardiac device constitute permissible withdrawal of life-sustaining treatment or impermissible euthanasia? As Noah observes, other scholars have addressed the legal questions at stake but not in the sustained way that he does. His article provides an impressive consideration of the issue and will provide valuable guidance to policymakers and scholars.
Why is the issue so difficult? On one hand, cardiac devices are forms of “artificial” medical treatment like ventilators, dialysis, or feeding tubes, and the law has clearly established the right to have any of those other treatments discontinued. On the other hand, implanted cardiac devices can become integrated into the patient’s body in a way that makes them seem like nearly perfect substitutes for the person’s failed cells. In this view, deactivating a pacemaker is not so much like removing a ventilator or discontinuing dialysis as it is like disabling a transplanted heart, which would constitute an act of euthanasia.
Consideration of ethics and law leads us to the principle that what really matters is whether the device supplements or replaces the patient’s own capacity and possibly whether the device is an imperfect or perfect replacement. At a minimum, device deactivation would constitute euthanasia only if the device replaced, rather than merely supplemented, the patient’s own capacity. It also might be necessary that the device be a perfect replacement for the patient’s own capacity before its deactivation should be considered euthanasia.
Number of Pages in PDF File: 8
Keywords: pacemakers, treatment withdrawal, euthanasia
JEL Classification: I18, K39Accepted Paper Series
Date posted: May 5, 2013
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