Pro: LVAD: Patient's desire for termination of VAD therapy should be challenged

摘要

AS VENTRICULAR ASSIST DEVICE (VAD) therapy for end-stage heart failure has become more prominent in the past decade, so have the psychosocial aspects of device management when patients face the end of life. A case is briefly presented to demonstrate the conflicting elements. The mechanical, emotional and ethical decision-making processes for management are discussed herein. The balance among patients' desires, resource utilization, caretakers' responsibilities, healthcare team, and physician obligation, is multifactor-ial and complex. The argument is espoused that a patient's desire to terminate LVAD therapy, singularly, and taken in the context of the above-mentioned factors, necessarily should be challenged.