CORRESPONDENCE: LETTER TO THE EDITOR
Reply
Nathan Goldstein, MD*,
Elizabeth Bradley, PhD and
R. Sean Morrison, MD
* Department of Geriatrics, Mount Sinai School of Medicine, Box 1070, One Gustave Levy Place, New York, New York 10029 (Email: nathan.goldstein{at}mssm.edu).
We thank Dr. Raphael and colleagues for their interest in our report (1). The investigators report their own findings, which demonstrate that patients with implantable cardioverter-defibrillators have relatively poor understanding of their device as it relates to options for deactivation. Their findings confirm our previous qualitative work with patients as well (2). The investigators point out that if physicians think patients understand options for deactivation, but in reality they do not, then this can be a reason that discussions about deactivation occur so rarely. We are in complete agreement with these investigators and did mention in our original contribution that this apparent incongruity between physician perception of patients' knowledge and what patients' actually understand poses a challenge to communication about deactivation. We thank Dr. Raphael and colleagues for highlighting this important issue in their letter.
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References
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1. Goldstein NE, Bradley E, Zeidman J, Mehta D, Morrison RS. Barriers to conversations about deactivation of implantable defibrillators in seriously ill patients: results of a nationwide survey comparing cardiology specialists to primary care physicians J Am Coll Cardiol 2009;54:371-373.[Free Full Text]2. Goldstein NE, Mehta D, Siddiqui S, et al. "That's like an act of suicide" patients' attitudes toward deactivation of implantable defibrillators J Gen Intern Med 2008;23(Suppl 1):7-12.[Medline]
Related Article
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Further Barriers to Conversations About Deactivation of Implantable Cardioverter-Defibrillators
- Claire Raphael, Prapa Kanagaratnam, and Darrel P. Francis
J. Am. Coll. Cardiol. 2010 55: 701-702.
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