Deactivation of Pacemakers at the End of Life

Abstract

The liceity of deactivating pacemakers and implantable cardio-defibrillators at the end of life has been considered only recently. The current discussion divides into two main camps: those who view deactivation as the moral equivalent of the withdrawal of other life-sustaining interventions, and those who hold deactivation as the equivalent of physician-assisted suicide. Some authors contend that similar to a transplanted organ, the pacemaker establishes an organic unity with the human body. Hence, its deactivation is equivalent to the removal or disabling of an organ. On the contrary, the relationship of a pacemaker to the human body is similar to other supportive mechanical devices. There are burdens associated with the presence of these devices. In the face of a terminal diagnosis, the deactivation of a cardio-pacemaker is morally similar to the withdrawal of other extraordinary measures currently accepted within the Catholic moral teachings.