Abstract

Based on the case report of Nathan Goldstein et al., “But I have a pacer…there is no point in engaging in hypothetical scenarios”: A Non-imminently Dying Patient’s Request for Pacemaker Deactivation, it is reasonable to conclude that it was, all-things-considered, ethically appropriate to grant the patient’s request to deactivate her pacemaker. Philosophically, and as a clinical ethicist, I support the team’s decision to honor the patient’s request for pacemaker deactivation. However, it is worth exploring a bit further whether the distress on the part of the outside hospital’s ethics committee and providers—who declined to honor the patient’s request for pacemaker deactivation—may actually track something of moral significance. In this commentary, I argue that there are reasonable grounds for holding that deactivation of a ‘biofixture’ such as a pacemaker may be more analogous in moral terms to medical aid in dying than it is to standard cases of withdrawal of life support at the end of a patient’s life.