Invited Commentary
Mar 11, 2013

Defibrillators, Deactivation, Decisions, and Dying Comment on “Patient Preferences for Deactivation of Implantable Cardioverter-Defibrillators”

Author Affiliations

Author Affiliations: Divisions of General Internal Medicine (Dr Matlock) and Cardiology (Dr Allen), Department of Medicine, University of Colorado School of Medicine, Aurora; and Colorado Cardiovascular Outcomes Research Consortium, Denver (Drs Matlock and Allen).

JAMA Intern Med. 2013;173(5):379-380. doi:10.1001/jamainternmed.2013.2130

In a medical culture where death is too often viewed as failure, clinicians and patients struggle to have high-quality discussions about deactivating an implantable cardioverter-defibrillator (ICD). The implications of this inaction are not trivial. In approximately half of hospices over the course of a year, patients dying of incurable disease will be shocked by their ICDs.1 Multiple societies have made recent calls for increased communication around ICD deactivation.2,3 However, exactly what form those conversations should take has yet to be determined.

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