In the last decades, new technologies have improved the survival of patients affected by chronic illnesses. Among them, left ventricular assist device (LVAD) has represented a viable solution for patients with advanced heart failure (HF). Even though the LVAD prolongs life expectancy, patients’ vulnerability generally increases during follow up and patients’ request for the device withdrawal might occur. Such a request raises some ethical concerns in that it directly hastens the patient’s death. Hence, in order to assess the ethical acceptability of LVAD withdrawal, we analyse and examine an ethical argument, widely adopted in the literature, that we call the “descriptive approach”, which consists in giving a definition of life-sustaining treatment to evaluate the ethical acceptability of treatment withdrawal. Focusing attention on LVAD, we show criticisms of this perspective. Finally, we assess every patient’s request of LVAD withdrawal through a prescriptive approach, which finds its roots in the criterion of proportionality.

在过去的几十年里，新技术提高了慢性病患者的生存率。其中，左心室辅助装置（LVAD）为晚期心力衰竭（HF）患者提供了可行的解决方案。尽管LVAD延长了预期寿命，但患者在随访过程中的脆弱性通常会增加，并且可能会出现患者要求撤回设备的情况。这样的要求会引起一些伦理问题，因为它直接加速了患者的死亡。因此，为了评估 LVAD 撤药的伦理可接受性，我们分析和检验了文献中广泛采用的伦理论点，我们称之为“描述性方法”，该方法包括给出维持生命治疗的定义，以评估停止治疗的伦理可接受性。我们将注意力集中在 LVAD 上，对这一观点提出批评。最后，我们通过规范性方法评估每位患者退出 LVAD 的要求，其根源在于比例标准。