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Published on: February 13, 2021

Ethical challenges in advanced heart failure

Vinay Kini1, James N Kirkpatrick

  • 1Cardiovascular Medicine Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Current Opinion in Supportive and Palliative Care
|January 19, 2013
PubMed

Insights

Caring for advanced heart failure (AHF) patients presents ethical challenges due to new therapies. Addressing these requires improved prognostication, informed consent, palliative care, and multidisciplinary approaches for optimal patient outcomes.

Area of Science:

  • Cardiology
  • Medical Ethics
  • Palliative Care

Background:

  • Advanced heart failure (AHF) is a growing concern with expanding treatment options.
  • Therapeutic and diagnostic interventions for AHF are increasing, leading to complex ethical dilemmas.

Purpose of the Study:

  • To discuss the ethical challenges in advanced heart failure care.
  • To propose an approach for managing patients with advanced heart failure.

Main Methods:

  • Review of recent guidelines and clinical trials on AHF therapies.
  • Analysis of ethical considerations related to advanced interventions.

Main Results:

  • Costly, invasive therapies like ventricular assist devices and cardiac resynchronization therapy prolong life but pose end-of-life challenges.
  • Prognostication, informed consent, and palliative care are crucial for managing decision-making.
  • Societal factors like cost-effectiveness and distributive justice impact device dissemination.

Conclusions:

  • Optimal AHF care necessitates further research and enhanced end-of-life education.
  • Emphasis on advance directives and comprehensive informed consent is vital.
  • A true multidisciplinary approach is essential for effective patient management.
Abstract

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