Navigation Links
Mayo Clinic finds withdrawing ventricular assist device support ethical

ROCHESTER, Minn. - Patients have the right to refuse or request the withdrawal of any unwanted treatment. In an article published in the online issue of Mayo Clinic Proceedings, investigators explore the legal and ethical permissibility of carrying out such a request specific to a ventricular assist device (VAD).

The left-VAD (LVAD) is a new technology that provides circulatory support for patients with severe heart failure who are awaiting a heart transplant. This technology also can serve as a long-term treatment option for patients who are not candidates for heart transplant, but still need circulatory support, also known as "destination therapy."

Notably, VAD technology is continuously improving. "A recent trial demonstrated significantly greater two-year survival among patients with severe heart failure treated with continuous-flow LVADs than among patients treated with older pulsatile-flow devices (58 percent versus 24 percent)," says Paul Mueller, M.D., lead investigator, Mayo Clinic Department of General Internal Medicine. At Mayo Clinic the two-year survival rate for patients treated with LVAD is 74 percent. Therefore, the VAD is a long-term treatment for patients with severe heart failure.

Nevertheless, some patients treated with VADs experience complications (e.g., stroke) related to their treatment or their underlying disease and request withdrawal of VAD support.

Dr. Mueller and colleagues describe 14 patients who requested (or their surrogates requested) withdrawal of LVAD support and these requests were carried out by their physicians. Dr. Mueller and colleagues then describe the ethical and legal permissibility of carrying out such requests.

"If the patient (or their surrogate) concludes that VAD support is more burdensome than beneficial, they may request withdrawal of VAD support (that is, that the device be turned off)," says Dr. Mueller. "Assuming the patient (or surrogate) is informed regarding alternatives to and consequences of withdrawing VAD support, clinicians should carry out such requests or transfer the patient's care to another physician. The cause of death in these cases is the underlying heart disease, not assisted suicide or euthanasia. In our view, carrying out such requests is permissible in accordance with the principles that apply to withdrawing other life-sustaining treatments." Examples are hemodialysis, mechanical ventilation and artificial hydration and nutrition.


Contact: Rebecca Finseth
Mayo Clinic

Related medicine news :

1. Clinical trials can be improved by managing the learning curve
2. Mayo Clinic Center for Innovation to sponsor a collaborative symposium on innovations in health care experience and delivery
3. Sickle cell treatment developed at LA BioMed enters Phase 3 clinical trial
4. UC San Diego receives major clinical and translational science award
5. Hopkins faculty lead development of report to FDA on ethical, scientific issues related to post-market clinical trials
6. Mayo Clinic Proceedings: Sexual abuse survivors have increased of psychiatric disorders
7. Mayo Clinic study finds apathy and depression predict progression from mild cognitive impairment
8. Pediatric clinical studies appear prone to bias, Hopkins review shows
9. St. Elizabeth Dental Clinic Named one of the Best in the Nation
10. Electronic health records prime clinicians to provide progressive care to older adults
11. CELLING Treatment Centers New Clinic Revolutionizes Spinal Care with Adult Stem Cells
Post Your Comments:
(Date:11/27/2015)... ... November 27, 2015 , ... Consistent ... sharing, the 2016 Building Better Radiology Marketing Programs meeting will showcase ... Sunday, March 6, 2016, at Caesars Palace in Las Vegas with a pre-conference ...
(Date:11/27/2015)... ... 27, 2015 , ... The moment you stop improving is ... fulfilling the needs of advisers and clients but going above and beyond to ... customer service. However, there's always room for improvement, which is why the entire ...
(Date:11/27/2015)... ... 2015 , ... The men and women on this list ... the country. They have overseen financial turnarounds, shown commitment to their community through ... as a whole through their advocacy and professional efforts. , Becker's Hospital Review ...
(Date:11/27/2015)... (PRWEB) , ... November 27, 2015 , ... ... contact center software Q-Suite, announces the incorporation of Asterisk 11 LTS (Long Term ... fully supported Asterisk 11 LTS brings Q-Suite 5.10 up-to-date with a version of ...
(Date:11/26/2015)... ON (PRWEB) , ... November 26, 2015 , ... ... of a real-time eReferral system for diagnostic imaging in the Waterloo region. Using ... BMD and Nuclear Medicine tests directly from their electronic medical record (EMR) without ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... India , November 26, 2015 ... --> adds ... Report" and "Investigation Report on China ... and 2021 forecasts data and information ... . ...
(Date:11/26/2015)... November 26, 2015 ... addition of the  "2016 Future Horizons ... Cell Surface Marker Testing Market: Supplier ... to their offering.  --> ... of the  "2016 Future Horizons and ...
(Date:11/25/2015)...  The American Academy of Pediatrics (AAP), American ... March of Dimes cheered today,s signature into law ... of 2015 (S.799), which takes much-needed strides ... to drugs, such as opioids, and to improve ... organizations have worked together leading advocacy efforts for ...
Breaking Medicine Technology: