Pacemakers and Cremation: Removal Protocol and Ethical Considerations

When a person with an implanted medical device, such as a pacemaker, wishes to be cremated, the removal of this device prior to cremation is a key practice observed in various cultures and by professionals in the field of funeral services. This article delves into the reasons for such removal, the process involved, and the ethical considerations behind the practice.

Reasons for Pacemaker Removal

One of the most compelling reasons for removing pacemakers before cremation is the presence of lithium-ion batteries. These batteries can pose a significant hazard during the cremation process, leading to explosions. This hazard is well-documented in various reports and by notable authors such as Iain Banks, who immortalized the scenario in his works, including The Crow Road ("It was the day my grandmother exploded").

Removal Process

During the preparation of the body for cremation, pacemakers are typically removed as a precautionary measure. This process is usually handled by the embalmer or another qualified medical professional. The removal is straightforward and minimally invasive, often requiring a small incision that can be easily closed with a couple of stitches.

Practical Steps in Removal

The pacemaker is typically found in the same area beneath the collarbone, making it relatively easy to locate and remove.

The pacing wires connected to the heart are usually left in place after the pacemaker is removed, as they are harmless and do not present a risk for the cremation process.

The removed pacemakers are then sent to electronic waste specialists for recycling, with the battery removed and separated for recycling, and the circuitry often separated for scrap or disposal as per local regulations.

Standard crematory retorts are not equipped to handle the potential explosion of an unremoved pacemaker, which could result in extensive damage to the retort and pose a safety risk to the individuals operating it. For this reason, pacemakers are always removed before the cremation process begins.

Ethical Considerations

While the removal of pacemakers is necessary for safety reasons, it also raises important ethical questions. Successfully fulfilling the wishes of the deceased and their family is a critical aspect of funeral practices. Forcing the family to choose an alternative method of disposal, such as burial, which is often more expensive, would be seen as disrespectful and non-inclusive. Therefore, family consent is typically sought, and if it is not obtained, the family is usually informed that they must choose a more expensive and potentially less popular option, such as burial.

Funeral homes are generally not equipped to handle the removal of complex or unusual medical devices, especially if no specific authorization is provided. As such, the removal process is typically handled by a professional who has the necessary skills and equipment to ensure a safe and respectful procedure.

Frequently Asked Questions

Does cremation risk the batteries of medical devices damaging the cremation oven?

Are breast implants also removed during cremation?

What happens to the removed pacemakers?

Conclusion

The removal of medical devices like pacemakers during the preparation for cremation is a necessary safety measure to prevent explosions and ensure the integrity of the cremation process. This practice is aligned with ethical considerations and the respect for the wishes of the deceased and their families.