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Original Question

Please, can you respond to the post written by one of my classmates. Smart pumps are “Infusion devices with software that sets parameters for fluid and medication infusion and communicates with pharmacy or medication administration systems.” (Hebda, 2019) They can range from implanted medication pumps that reside in patient’s bodies, like insulin or pain pumps, to external infusion pumps that administer medications via IV access. People also can take chemo treatments home that will run off of a pre-programed pump over a period of time, so they can spend time with their families in the comfort of their own homes instead of infusion centers. Pacemakers help to keep hearts pumping at a designated beat per minute and ICD’s can defibrillate people if their heart stops. Technology has improved and prolonged people’s lives. Legally, Sometimes, these pumps are almost too smart. They do their jobs too well and sustain someone’s life when they shouldn’t. For instance, if someone is riddled with metastatic cancer and has no chance of recovery and is in immense pain, I believe that ethically, we should allow them to pass, not keep them alive to continue suffering. If the patient has an ICD, it will repeatedly shock the heart to keep them alive and continue to shock them even after they pass. That seems cruel. Also, as patients near death, their heart rate usually increases initially, and then drops and respirations decrease. A pacemaker would help to keep their heart pumping and sustaining the tissues of oxygen rich blood, keeping them alive and not allow nature to take its course. Privacy is both enhanced and decreased by the use of this technology. Computers store this data and with the click of a button or the scan of barcode, a persons information is sent to communicate with these pumps. This allows personal information to be verified without the person having to divulge all of their info every time they require a treatment. It puts them at risk for a breech in their information however because almost every server can be hacked, and information can be stolen and used for all sorts of nefarious deeds. Ethically, overall, I think smart pumps have been a wonderful addition to enhancing people’s health and lives. The only instance I can think of were this may not be case is someone who has an ICD and has reached end of life. Legally, we as nurses cannot turn off a pacemaker, it must be a physician. If it is turned off too soon, the patient could die prematurely which could be constituted as murder. I encountered a situation like this with an in-pt. hospice patient. The family wanted me to turn off the ICD so that he could pass without being shocked back to life. Ethically, I agreed with what they were saying but legally, I could have lost my nursing license or even faced jail time, had I complied. Also, smart pumps still allow for the possibility of error. “The reality of programming an IV smart pump is that the delivery of even a single dose of medication involves multiple steps and keystrokes, each of which introduces a potential opportunity for error. “(Giuliano, 2021)

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