• Michael Pottash and Anirudh Rao.
• Division of Palliative Medicine, Department of Medicine (M.P., A.R.), MedStar Washington Hospital Center, Washington, DC, USA; Georgetown University School of Medicine (M.P., A.R.), Washington, DC, USA. Electronic address: Michael.Pottash@Medstar.net.
• J Pain Symptom Manage. 2024 Mar 1; 67 (3): 274278274-278.

AbstractThe left ventricular assist device (LVAD) is a fully implantable cardiac replacement device that can complicate the process of dying. We present a case of a patient who attempted to deactivate the LVAD without the support of his medical team. This action was understood as a "suicide attempt" though when the patient was later felt to be dying, LVAD deactivation proceeded without reference to psychiatric illness. To understand this case, we discuss the ethics of LVAD deactivation in the dying process. We then explore the experience of clinicians and the public encountering this unique technology across clinical contexts. We herein present a novel and possibly controversial analysis of the moral complexities of LVAD deactivation and suggest that clinicians be transparent about these complexities with patients and families.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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