ISBN: 978-1-4731-3093-7 Table 147: Finding 1: Attitudes and understanding Sub-finding Statement of sub-finding Awareness ICD recipients and family members were unaware that ICDs could be deactivated. Misconception People perceived deactivation to be equivalent to euthanasia or suicide, resulting in immediate death Not wanting to deactivate People did not want to deactivate regardless of the circumstances Wanting to deactivate People wanted to deactivate when they were bedridden with an extremely low quality of life Table 148: Finding 2: Discussions Sub-finding Statement of sub-finding Initiating the conversation Some patients felt that healthcare professionals should start the conversation, whereas others felt that this would be emotionally distressing Starting the conversation early Some felt that discussions should be started early while they were able to make decisions Having the conversation later Some felt discussions should occur later on or when there was a change in their condition Avoiding discussions ICD recipients and healthcare professionals avoided discussions about deactivation Table 149: Finding 3: Decision making Sub-finding Statement of sub-finding Healthcare professionals decide People with ICDs felt that healthcare professionals should decide whether or not a device should be deactivated Patients decide Healthcare professionals felt that patients should decide when to deactivate their device. 10.3.3.3.1 Narrative summary of review findings Finding 1: Attitudes and understanding Review sub-finding 1: Awareness Many ICD recipients and family members were not aware that ICDs could be deactivated. Their doctors had not discussed this with them, and they had not thought about the issues related to end of life care. Finding this out came as a surprise for many, and they reported that thoughts about dying were not discussed between them, their spouses and their healthcare professionals. 