Karches Kyle E, Sulmasy Daniel P
Department of Medicine, The University of Chicago Medicine, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Department of Medicine and Divinity School, The University of Chicago Medicine, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Card Electrophysiol Clin. 2015 Sep;7(3):547-55. doi: 10.1016/j.ccep.2015.05.012. Epub 2015 Jun 24.
The 2010 guidelines regarding management of cardiovascular implantable electronic devices (CIEDs) conclude that patient requests to deactivate these devices at the end of life should be honored. Nevertheless, many clinicians and patients report feeling uncomfortable discontinuing such therapies, particularly pacemakers. If the principles of clinical ethics are followed, turning off CIEDs at the end of life is morally permissible. Clinicians managing CIEDs should discuss the option of deactivation with the patient at the time of implantation and be prepared to reopen the question as warranted by the patient's clinical course and respect for the patient's authentic values.
2010年关于心血管植入式电子设备（CIEDs）管理的指南得出结论，应尊重患者在生命末期停用这些设备的请求。然而，许多临床医生和患者表示，停止此类治疗，尤其是起搏器治疗，会让他们感到不舒服。如果遵循临床伦理原则，在生命末期关闭CIEDs在道德上是允许的。管理CIEDs的临床医生应在植入时与患者讨论停用的选择，并准备好在患者的临床病程和对患者真实价值观的尊重所要求的情况下重新提出这个问题。
