Legality of Deactivating Implanted Cardiac-Assist Devices

Lars Noah addresses an increasingly relevant issue that has been largely neglected by legal academics.  In "Turn the Beat Around?: Deactivating Implanted Cardiac-Assist Devices," Noah observes that with the growing utilization of pacemakers, ICDs, and LVADs, physicians increasingly encounter patients who ask that their still-functioning devices get turned off.  



Noah notes that most medical ethicists equate deactivation with the permissible withdrawals of other (typically external) interventions.  But Noah argues that implanted cardiac-assist devices pose serious challenges to the well-accepted equivalence between initially refusing and later requesting the withdrawal of life-sustaining treatments. In order to eliminate residual uncertainties about the lawfulness of this peculiar form of physician-aid-in-dying, he recommends legislative attention to the problem.