This has come up a few times in the past, and has recently reared it's head. I have a patient with a defibrillator who is actively dying. RN says we must get it deactivated, or pt will get shocked when heart stops, causing undue distress to the family. Hospice MD says this is a non-issue because you are shocking dead tissue. Seasoned hospice RN tells me that defibrillators only kick in at HR over 200 so it is a non-issue. I have not yet seen a pt die that has been shocked with defibrillator or pacer, and I have cared for both. However, other hospice crisis care nurses have told me they have observed such a thing happening, and it is very distressing. To me, asking the family to have the defibrillator deactivated - having the MD giving order then watching someone come out to deactivate - is a traumatic experience, on top of losing their loved one. However, it certainly would be traumatic to witness your loved one getting shocked, too.
What do y'all think - what has your experience been? The patient most likely is on his way to heaven by now, but for future reference...