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A Loved One is Dying: When Should You Turn Off Their Pacemaker or Defibrillator?

David Mokotoff, MD
4 min readFeb 22, 2025

Modern-day medical devices can extend a dying patient's life, but not for long.

Courtesy of Wiki Commons

There is little more distressing than watching a loved one dying, and yet their heart appears to keep on beating. The heart is not beating, but an electrical monitor continues to show blips of a “heartbeat.”

I have witnessed this hundreds of times, and although it doesn’t last long, family members become reasonably shocked and upset to see electrical activity on a heart monitor while the patient appears otherwise unresponsive and dead.

The invention of cardiac pacemakers (PM) and implantable cardio-defibrillators (ICD) has helped extend many patients’ lives by years. Yet, when death is near, the angst of deciding to turn off another form of “life support” arises. Many of these cardiac patients develop other terminal illnesses, such as cancer, and how to deal with the device before death is important.

Many “living wills” or “advanced directives” documents don’t specify how to handle disabling these devices. There is value in thinking about this subject to allow a more peaceful death. But before delving into this, we must understand how each device works.

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David Mokotoff, MD
David Mokotoff, MD

Written by David Mokotoff, MD

David Mokotoff is a top and boosted writer. He is a retired MD, passionate about health, medicine, gardening, and food, https://tinyurl.com/y7bjoqkd

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