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How Should Physicians Respond to Requests for LVAD Removal

Bibliographic Data

ID15744840
AuthorsLarry A Allen (0000-0003-2540-3095, University of Colorado Boulder, corresponding author)
Year2019
Volume21
Issue5
PagesE394-400
Publication date2019-05-01
Open AccessYes
TypeARTICLE
VenueThe AMA Journal of Ethic (JOURNAL)
Journal identifiersISSN: 2376-6980 • E-ISSN: 2376-6980
PublisherAmerican Medical Association (PUBLISHER • US)
DOI10.1001/amajethics.2019.394
PMID31127918
OpenAlexW2942832374
LanguageEN
Citations received1
References cited3

Mechanical circulatory support devices, including left ventricular assist devices (LVADs), have become mainstream treatment for end-stage heart failure. LVADs are ethically and legally no different than other types of life support, for which patients have a right to decline or withdraw care consistent with the principle of respect for autonomy. However, the realities of LVAD complicate informed consent and shared decision making. LVAD candidates are often older and have multiple illnesses. And life with an LVAD requires a period of comprehension, adaptation, and reintegration. Therefore, clinicians must assess LVAD candidates' decision-making capacity, screen and possibly consult for depression, seek to understand whether being on LVAD is consistent with patients' values, consider temporary support options to allow for goals clarification, and ask for help from family and palliative care specialists

Autonomy · Cardiology · Heart failure · Intensive care medicine · Palliative care · Cardiac Arrest and Resuscitation · Family and Patient Care in Intensive Care Units · Mechanical Circulatory Support Devices · Medicine · Nursing · Psychology

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    Open Access•Larry A Allen•The AMA Journal of Ethic•2019

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  • How Should Physicians Respond to Requests for LVAD Removal

    Open Access•Larry A Allen•The AMA Journal of Ethic•2019

Citations per year0.14
Citation span2019 - 2019 (1)
Highly citedNo

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