Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
To the Editor: Dr Rhymes and colleagues1 agreed that removing a low-burden intervention,
such as a pacemaker, from a chronically ill patient is not necessarily unethical.
However, the pacemaker of the patient described, Reverend G, is an indwelling
device that had arguably become a part of him. It is thereby distinguishable
from extrinsic treatments like ventilatory support, hemodialysis, or artificial
hydration and nutrition. Thus, acts interfering with pacemaker function would
be more akin to killing than to letting die.
Paola F, Walker RM. Is It Ethical to Withdraw Low-Burden Interventions in Chronically Ill Patients?. JAMA. 2000;284(11):1380-1382. doi:10.1001/jama.284.11.1378