Ethical Challenges and Implications of Deactivating Mechanical Circulatory Support for Patients With Preserved Cognitive Function

Activity Summary

Required reading for all learners: Implicit Bias impacts patient outcomes

The advent of Mechanical Circulatory Support (MCS) has made it possible for patients with end-stage heart failure to move even farther along the disease trajectory. What prevails are increasingly complex clinical cases, which challenge both the limits of medical and mechanical management as well as our attitudes surrounding [medical futility/patient autonomy and the ‘locus of decisional authority’ when it comes to end-of-life decision-making. Maintaining space for patient autonomy, can be challenging, especially with respect to deactivation of MCS in cardiac patients who are cognitively intact. Despite the rigors of informed consent and a steadfast commitment by the surgeon and care team to uphold the implicit care contract, the decision to deactivate or withdraw mechanical support rests with the patient. Nurses play a pivotal role in safeguarding patient autonomy and supporting surgeons and care teams in accepting and upholding these difficult choices.

Objectives

Identify steps nurses can take to facilitate an ethically minded approach to decision-making for patients with mechanical circulatory support (MCS).
Reflect on your role as a nurse in assisting care teams to honor a patient’s desire to discontinue mechanical therapies.
Define the process of informed consent as it pertains to the process of informed decision-making.

Continuing Education Disclosure Statement

Successful Completion

Learners must complete the entire activity and the associated evaluation to be awarded contact hours AND read Implicit Bias impacts patient outcomes. No partial credit will be awarded.

Accreditation

The American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
Provider approved by the California Board of Registered Nursing, Provider number CEP 1036, for {contactHours} contact hours.

Disclosures

Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content will be identified by the Nurse Planner within the activity. Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content has been mitigated.

Accreditation refers to recognition of continuing education only and does not imply AACN, ANCC, or CBRN approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity. Activities with pharmacology hours are to assist the APRN in fulfilling the pharmacotherapeutic education requirements for licensure and certification renewals.

Activities meet the standards for most states that require mandatory continuing education for license and/or certification renewal. AACN recommends consulting with your own state board of nursing or credentialing organization before submitting your certificate of completion.

Refund Policy

Continuing Education Activities are nonrefundable.