Is It Permissible to Shut Off this Pacemaker?

In the case study “Is It Permissible to Shut Off this Pacemaker?” (Yates & Orr, 2008) there are dilemmas, facts and ethical principles that must be looked at in order to do a proper analytical analysis. The writer will discuss the persons/agents involved, the main dilemma, state the facts, ethical and moral principles that are relevant, as well as assess and try to resolve the dilemma.

Persons/Agents in Case

The main persons involve in this are the patient and patients’ family along with health care professionals that work for the hospital or within primary care. Dorthea is the main person involved. Her family consists of her daughters, grandchildren and great grandchildren. The agents involve at the hospital are the cardiologist, ethics consultant and her primary care physician.

Dilemma

The main dilemma in this case study is that the patient wants her pacemaker shut off. She wants to stop the pacemaker as she believes this will end her life. She wants to end her life because she is miserable and feels she is making her family miserable. Although she believes this will end her life the cardiologist and primary care physician know that is not necessarily true. This could be a much longer process than she may think. Now the ethics consultant has been asked to meet with Dorthea and her family regarding the ethical/moral issues and medical rules about this dilemma.

Examining the Facts

Dorthea is a 69 year old woman who until about 5 years ago was healthy. Her husband passed away 3 years ago. In the past 5 years she has developed diabetes, decreased kidney function and transient heart block. Diabetes is a “lifelong condition where either your body does not produce enough insulin, or your body cannot use the insulin...

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...ie might be of more importance as it seems she is doing this because she feels like she is a burden to family. Maybe having counselling and social work involved could help her see that her life may be worth living. Ultimately in this case we need to realize that if the pacemaker is removed she will not die from its removal. She will die from the secondary complications of having an ineffective pumping heart and therefore will die from other comorbidities. In health care it is difficult to keep in mind that “autonomy may come into conflict with other values such as beneficence and justice” (Yeo, Moorhouse, Khan, & Rodney, 2010, p. 197). This primary physician has asked the ethics consultant to address the question of shutting it off and therefore brings the writer to believe he is willing to do so as long as all the legal, ethical, and moral bases are covered.