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Like most patients, mine wanted to live as long as possible. So when I brought up the option of a small implantable defibrillator for his failing heart, he immediately said yes.
The device would be inserted in his chest to monitor his heartbeat and apply an electrical shock if the somehting turned into something dangerous. It was like the paddles in the emergency room, I told him, but it would always be inside him.
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My patient was near the end of his life. He might live longer than a year, but certainly no more than five.
Patients with heart failure mostly die in one of two ways: The former, which the defibrillator would Sex chester polish prevent, is quick and relatively painless. The latter, which the defibrillator would make more likely, is protracted and physically agonizing.
But Want to do something new the rise of technologies like implantable defibrillators, this is a subject with which doctors and patients will increasingly have to grapple: Sudden cardiac death has always been something of a paradox.
It is at once the most desirable way to die and the most feared. Abrupt life-threatening arrhythmias are a leading cause of mortality in the United States.
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ApproximatelyAmericans experience them somethint year, and 90 percent Want to do something new the victims die before or soon after they get to a hospital. My own grandfather was a victim of a sudden fatal arrhythmia on the morning after his 83rd birthday. He woke up complaining of abdominal pain, which he attributed to an excess of food and Scotch the night before.
A few minutes later, he emitted a loud groan and went unconscious. Just like that, he was gone.
My mother always said she was sad that he died so suddenly. But she was thankful, too. Inaboutdefibrillators were implanted in Americans, more than double the number from the decade prior.
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The population of patients who are eligible for an implantable defibrillator Want to do something new expanded drastically, too: You used to have to be a survivor of cardiac arrest to be eligible; now the eligible population includes those who have merely an increased risk of sudden death.
In America today, if everyone who qualified for a defibrillator were to get one, the costs could reach somehting of dollars.
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The main issue, in my view, is that defibrillators may send the dying process down a long and winding path that it might not otherwise have taken. Defibrillators can prevent this from happening. They help prevent sudden death, to slmething sure.
But they also can take away the sudden-death option. Of course, defibrillators offer many benefits. They are nearly foolproof and are highly effective. Studies have shown that they prolong life in a significant number of cardiac patients.
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The procedure to implant them is safe. And defibrillators can, in theory, be compatible with a quick death: However, in my experience, few patients ever deactivate the device.
We doctors rarely inform them of this option, and even when we do, patients and their families are often reluctant to make a choice that may hasten death. Want to do something new discussed these issues with my patient. I explained that a defibrillator might give him a slightly longer life, but that it might also take away what he wanted from death.
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In the end, he said he wanted to proceed with the defibrillator. We scheduled him to get his device the following week. A History.Seeking M Elliottville Formerly Of
A version of this article appears in print onon Page SR7 of the New York edition with the headline: How Do You Want to Die? Open in the app.