OBJECTIVE: To describe a series of terminally ill @entity1 who requested (or whose surrogates requested) withdrawal of pacemaker or @entity737 ( @entity737 ) support and the ethical issues pertaining to these requests. @entity1 AND METHODS: We performed a retrospective review of the medical records of @entity1 seen at the Mayo Clinic in Rochester, Minn, between January 1996 and June 2002 and identified 6 terminally ill @entity1 who requested (or whose family members requested) withdrawal of pacemaker or @entity737 support. Potential interventions were an ethics consultation and subsequent withdrawal of pacemaker or @entity737 support. The study's main outcome measures were @entity204 and the context in which it occurred. RESULTS: The mean age of the 6 @entity1 (3 @entity1 , 3 @entity1 ) was 75.5 years. Five had pacemakers, and 1 had an @entity737 . Five @entity1 had advance directives that indicated a desire to withdraw medical interventions if @entity204 was inevitable. Two @entity1 and 4 surrogates requested withdrawal of pacemaker or @entity737 support. One @entity1 died without withdrawal of support despite an ethics consultation that endorsed its permissibility. Another died while an ethics consultation was in progress. The request to withdraw support was granted in 4 @entity1 , all of whom died within 5 days of withdrawal of support. CONCLUSIONS: Granting terminally ill @entity1 ' requests to withdraw unwanted medical support is legal and ethical. Death after withdrawal of support is attributable to the @entity1 's underlying pathology and is not the same as physician-assisted suicide or euthanasia. Clinician familiarity with these concepts may lead to more expeditious withdrawal of unwanted medical support from terminally ill @entity1 .

Ethical analysis of withdrawal of pacemaker or XXXX support at the end of life.

@entity1 :: ('9606', 'Species') :: ['men', 'women', 'patients', 'patient', 'PATIENTS'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity737 :: ('MESH:D057873', 'Disease') :: ['ICD', 'implantable cardioverter-defibrillator']
@entity737 :: (MESH:D057873,Disease) :: ['implantable cardioverter-defibrillator']
