According to Dr. Nitschke (Peaceful Pill Handbook), it is not a problem.
The pacemaker doesn't change the effectiveness of the hypoxic, hypemic or histotoxic drugs/gases etc like nitrogen, Nembutal, sodium nitrite, CO, sodium azide etc etc.
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The following is stated in the Dutch Euthanasia and Assisted Suicide Guidelines regarding pacemakers:
SPECIAL SITUATIONS
Implantable Cardiac Devices
There are two types of CIEDs (Cardiac Implantable Electronic Devices):
- Pacemakers
- ICDs (Implantable Cardioverter Defibrillators)
Pacemakers (DDD, VVI, CRT-P)
In general, pacemakers are not deactivated in the terminal phase of life. The dying process is not directly affected by the presence of a functioning pacemaker. In rare exceptions, deactivation may be considered, but reprogramming the pacemaker could reduce the patient's comfort. Consultation with a cardiologist is mandatory before deactivating the pacemaker.
ICDs (ICD, CRT-D)
It is recommended to reprogram an ICD (defibrillator) in the dying phase. This means disabling the therapy that treats rapid heart arrhythmias. This does not affect the dying process. Deactivation should be discussed/considered in a timely manner so that the patient can have their device reprogrammed in an outpatient setting at the hospital where they are registered. If the terminal phase begins earlier than expected and the ICD has not yet been deactivated, placing or attaching a magnet to the device may be considered. Magnet application disables the therapy for rapid heart arrhythmias, but the pacemaker function of the ICD remains unaffected and does not influence the dying process.
How to switch off an ICD at home for end of life care
