Courses and Information

Pacemakers & Internal Defibrillators

One of the most common questions received by the Academy’s Clinicians Hotline is about how to work with a patient requesting aid in dying who has a pacemaker and/or internal defibrillator. The answer is different for each one.

Summary: For both pacemakers alone and pacemaker/ICD combinations, it’s fine to do nothing and proceed with aid in dying as you otherwise would. But if you can turn off the ICD, that’s often a good choice.


Summary: When a patient says they’ll turn off their pacemaker and thus qualify for aid in dying, the clinicians response must be based on detailed information about the patient’s underlying cardiac abnormality, the reason the pacemaker was placed, and the likely outcome of turning off the pacemaker—before considering whether the patient may qualify for aid-in-dying care.


Summary: Qualifying a patient for aid in dying by their request to turn off their pacemaker, and then turning off the pacemaker chemically during the aid-in-dying procedure, is controversial. Each clinician must make their own decision about the legal, ethical, and pharmacologic considerations.


Teaching and supporting best practices for the care of patients considering or completing medical aid in dying.

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