Heart failure & cardiomyopathies
Interprofessional Clinician Perspectives on Left Ventricular Assist Device (LVAD) Deactivation Compared to Dialysis Discontinuation: A Cross-Sectional Study Using Vignettes
Authors' conclusion
When compared to requests to discontinue hemodialysis, clinicians perceive LVAD deactivation as more ethically complex and were less likely to honor the patient's request. These differences persisted across clinical scenarios, from acutely ill to chronically ill to independent.
Study context
- Population
- Interprofessional clinicians at a heart and vascular center, April 14, 2023, to June 5, 2023clinicians agreed to be interviewed (27.5% physicians, 23.8% nurses, 17.5% physician trainees, 16.3% advanced practice providers, and 15% social workers, bioethicists, and chaplains)
- Participants
- 80 clinicians
- Comparison
- LVAD deactivation compared to cessation of hemodialysis
- Outcome
- Ethical complexity and likelihood of honoring the request
Methodological detailspaired vignettes, Likert-scale responses, single heart and vascular center
- Paired vignettes
- Likert-scale responses
- Single heart and vascular center
Main finding
As reported in the abstract
- LVAD deactivation vignettes rated more ethically complex and less likely to be honored than dialysis discontinuation across clinical scenarios
- P < 0.001
Further findings
Scenarios describing the patient without other medical comorbidities ("tired of life")
- More likely rated ethically complex and less likely to suggest honoring the patient's request, for either LVAD or dialysis
- P < 0.001
- These trends remained consistent across all demographic and clinician disciplines.
Original publication
Interprofessional Clinician Perspectives on LVAD Deactivation Compared to Dialysis Discontinuation: A Cross-Sectional Study Using Vignettes. JACC Adv. Published 30 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →