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Lifesaving devices can cause havoc at life's end

New York Times, May 14, 2010

With a rapidly growing number of patients getting defibrillators, they are increasingly posing a bionic challenge near life's end for both patients and their families. Specialists say that a failing heart often begins to beat in the same type of wildly erratic rhythm that a defibrillator is programmed to recognize and intercept with a jolt. And though doctors and patients routinely discuss end-of-life issues like withdrawing medications and resuscitation attempts, studies suggest that what to do about a defibrillator rarely comes up. The Heart Rhythm Society, a professional group representing cardiologists who implant heart devices like defibrillators, plans to issue guidelines in an effort to promote such talks.