Ethics Imperative: Implications of Caring for Cardiac Patients at the End of Life

This case study discussion of existential suffering, conscientious objection, ethical drift and moral distress is significant for many patients in hospice/palliative care. A review of end-stage cardiac patients with implanted devices will demonstrate the ethical challenges. Reframing the perspectives of patients and clinicians may create growth opportunities for the interdisciplinary team with positive impact on interactions and teaching. Objectives include exploration of unique challenges and opportunities for therapeutic approaches to establishing goals of care for patients; ongoing perceptions of clinicians at the bedside; potential conflict areas, moral dilemmas, and ethical drift; examples of engaging patient/families which may result in increased professional fulfillment and review of ethical imperatives with future challenges as technology and access increase.