13 Jun left ventricular assist device: (LVAD)
Question
You are the healthcare administrator for a cardiology practice. The cardiologists implant into certain patients, a device that is called a “left ventricular assist device: (LVAD); a mechanical device that assists the left ventricle to pump as much blood as possible into the rest of the body. A LVAD is usually implanted for individuals with chronic heart problems whose quality of life is deteriorating and who are not candidates for heart transplants. Some of the controls for the device including the battery pack reside on the outside of the patient. A particular patient who received a LVAD six months ago is now asking for the device to be “turned off” with the realization that at this point in his disease process, he will likely die within a short period of time (hours to a few days) if the device is “turned off”. The cardiologists are “split” on what to do in this situation. Some members of the staff are adamant that the device remain connected as the patient willingly and with full informed consent agreed to accept the device while others are just as adamant that the patient has the right to have the device turned off even if it means death. The Board of Directors of the cardiology practice has asked you as the healthcare administrator to draft policy guidelines re this situation for them to consider for the next board meeting. What principles might the administrator use in approaching this dilemma
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