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Elisabeth Kübler-Ross significantly advanced psychology's understanding of the process of dying with her influential book, On Death and Dying (1969). She focused on studying terminally ill individuals and outlined five stages commonly experienced when coping with death: denial, anger, bargaining, depression, and acceptance.
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Refusing Technology, Accepting Death: My Father's Story.

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    Summary

    Implantable cardioverter defibrillators (ICDs) may become burdensome for elderly patients. Reconsidering ICD use in advanced age is crucial to ensure cardiac care improves quality of life.

    Area of Science:

    • Cardiology
    • Geriatrics
    • Medical Ethics

    Background:

    • Increased use of life-sustaining medical technology near end-of-life presents new challenges.
    • Historically, mortality was viewed more circumspectly due to limited technological interventions.
    • Potential overuse of medical technology, including implantable cardioverter defibrillators (ICDs), warrants examination.

    Purpose of the Study:

    • To evaluate the appropriateness of implantable cardioverter defibrillators (ICDs) in elderly patients.
    • To address the ethical considerations of burdensome cardiac care despite limited benefits.
    • To explore challenges in health literacy, death acceptance, and resource allocation concerning ICDs.

    Main Methods:

    • Literature review on ICD use in end-of-life care.

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  • Ethical analysis of technology burden versus benefit.
  • Discussion of patient factors like advanced age and health literacy.

    • Main Results:

    • ICDs, used for fatal arrhythmias, may pose a burden in advanced age.
    • The question of when ICDs become too burdensome is inadequately addressed.
    • Challenges in acceptance of death and resource allocation require attention.

    Conclusions:

    • ICD implantation should be reconsidered for patients with advanced age.
    • Addressing health literacy, death acceptance, and resource allocation is vital.
    • The goal is to prevent burdensome cardiac care that does not enhance quality of life.