Re: Dementia Patient needing pacemaker

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none Re: Dementia Patient needing pacemaker

I am amazed at all the posts since I posted last several years ago about our family's dilemma. It's a tough situation. I encourage everyone with a demented parent "needing" a pacemaker to read "What Broke My Father's Heart," a detailed investigation of this issue in the New York Times magazine in June 2010. (Google "What Broke My Father's Heart" AND "New York Times" and it should pop up. )
My mother and I finally asked my father's doctor to deactivate his pacemaker. It can be done painlessly, without surgery. According to US law and medical ethics, a patient has the right to request the withdrawal of any medical treatment, and family members (or others) who have been named in a durable power of attorney document have the right to request withdrawal IF the patient is incompetent AND would have wished to have the pacemaker withdrawn in such circumstances when he or she was in his/her right mind. That doesn't make it easy. The cardiology associations issued a joint ethical statement in May 2010 saying that this is neither assisted suicide nor euthanasia.
If you are having trouble, ask to be referred to the palliative care department or the ethics committee at the hospital, if there is one, or hospice, or look for a more sympathetic cardiologist. Better yet, go deep into your own moral values and resist the devices when dementia is on the horizon, if prolonging misery this way goes against your moral values or common sense. We were pressured into the pacemaker and were unable to persuade my father's cardiologist to turn it off later, and my father finally died of pneumonia on a hospice unit. One way or another, the end of life is often painful, and don't be guilt-tripped into thinking medicine can postpone death and suffering forever. There are worst fates than death, and I have seen them -- as have many of you.

Posted on 2011/10/25 22:44

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