Guidance from the Resuscitation Council, the British Cardiovascular Society and the National Council for Palliative Care
Clear challenges arise when people with an implanted device approach or reach the end of their life. What many people want in that situation is care and treatment to maintain their comfort and quality of life for whatever time they have left . Receiving treatment (for example electric shocks from an implanted defibrillator) as they are dying may provide no benefit but may cause them pain and may cause distress both to them and to those who care about them.
So as to provide the best care for people in the last days, weeks or months of their life it is important to consider deactivation of some of these devices. This requires informed and sensitive discussion with patients and those close to them. Healthcare professionals caring for such people may be faced with practical questions about the exact nature and purpose of each device, how the device can be deactivated and what arrangements are in place in their locality to provide the equipment and the expert support and advice needed. It is important also that healthcare professionals know what actions should be taken when someone has died with an implanted device in place.
Quite distinct from those circumstances, an implanted device may lead to uncertainty when someone with one in place suffers cardiac arrest, and cardiopulmonary resuscitation (CPR) is attempted. Those involved may not have detailed information about the implanted device and may be unsure whether they should modify their approach to CPR.
Dr David Pitcher, President of the Resuscitation Council (UK) says,