Current Trends - End-of-Life Decisions: Can you Donate a Pacemaker? - Episode 196
- Jenny Rozelle, Host of Legal Tea
- May 13
- 6 min read
Hey there, Legal Tea Listeners – This is your host, Jenny Rozelle. Welcome back! Welcome back for another episode, which is a “current trends” topic where we talk about things going on currently that are relevant and pertinent to my estate and elder law world, and/or maybe things I’ve seen on the news or stumbled across on social media. Well for today’s episode, we are going to talk about something kind of unique – pacemakers and giving them a “second life.” Many episodes ago, in episode 97, I did an episode on human composting and water cremation, called aquamation, and something that I talked about in that episode is what happens with people’s medical implants, like pacemakers, when someone’s body gets cremated, for example. Check that episode out – it was a really interesting one with some ethical considerations, environmental considerations, etc. Anyway, I saw a recent article talking about a “pacemaker recycling program” and thought, “Well that may be interesting to talk about on the podcast” so here we are … let’s dive in and talk about it!
What inspired this episode was a story out of Hamilton County, Indiana – and the story is, of course, linked in the source links for this episode. In a groundbreaking and compassionate move, the Hamilton County Coroner’s Office (in Indiana) has joined an initiative aimed at giving USED pacemakers a second life. This effort, which is so innovative that it freaks some out, involves collecting pacemakers from deceased individuals and sending them to underserved populations around the world. These devices, once properly sterilized and tested, are donated to patients in developing nations who would otherwise have no access to such life-saving technology. You may be wondering … well, did Hamilton County come up with this idea? No. Not really at all. It was just the story I found – that’s it.
In fact, this Hamilton County, Indiana program is part of a broader effort led by organizations such as University of Michigan’s My Heart Your Heart (MHYH) Project. This project focuses on ethically collecting explanted pacemakers, refurbishing them under strict safety protocols, and redistributing them to qualified medical institutions in countries with limited healthcare infrastructure. Each recycled device holds the potential to prolong, or even save, the life of someone who might not have any other option.
Dr. Jeff Jellison, the Hamilton County, Indiana Coroner, emphasized the deeply human element of this mission. For many families, knowing that their loved one’s pacemaker can continue to help someone in need provides a sense of peace and purpose amidst grief. The coroner’s office works closely with funeral homes, pathologists, and organ recovery teams to ensure that devices are retrieved in a respectful and dignified manner. Once collected, the pacemakers undergo a stringent reconditioning process. This includes sterilization, evaluation for battery life, and testing of all device functions. Only those that meet strict medical standards are approved to use again … or re-use, I should say. The process ensures that safety and quality are never compromised, while also addressing a significant global health inequity.
The impact of these efforts is profound. In many low-income countries, the cost of a new pacemaker—often thousands of dollars—is far beyond the reach of the average patient. This reality leaves many with treatable heart conditions without hope. Through this initiative, hundreds of patients now have the opportunity to receive life-altering cardiac care, thanks to devices that would have otherwise been discarded. Furthermore, this collaboration reflects an environmentally-friendly approach to healthcare. Medical waste, especially from electronic devices like pacemakers, poses a growing concern, but is not talked about very much – but it is very much an issue. So by refurbishing and redistributing these devices, the program not only extends human life but also reduces the ecological footprint of medical disposal. I’d call that a … win, win!
Looking ahead, Dr. Jellison, with Hamilton County, Indiana’s Coroner’s Office, hopes that other counties and states will follow suit. By building a national network of coroner’s offices, hospitals, and academic institutions committed to recycling pacemakers, the reach and impact of the program could grow exponentially. With thousands of pacemakers implanted and explanted each year, the potential for saving lives is staggering. And at its core, this initiative speaks to the power of compassion and collaboration. It is truly a reminder that the end of one life can help preserve another—and that medicine, even beyond the grave, has the potential to heal. Some even compare it to organ donation – similar process and thinking, just different at the same time.
You may be thinking, “So is this new news, old news, what is the status of all of this?” Well, let’s talk about that…
Pacemaker recycling is a relatively new and evolving concept in the medical field, which like we’ve talked about, is aiming to address the disparity in access to life-saving cardiac devices between high-income and low-income countries. Traditionally, pacemakers have been designated as single-use devices, primarily due to safety concerns and regulatory restrictions. However, initiatives like University of Michigan’s My Heart Your Heart (MHYH) Project, spearheaded by the University of Michigan's Frankel Cardiovascular Center, are challenging this notion by demonstrating that, with proper sterilization and testing, reconditioned pacemakers can be safely reused.
University of Michigan’s My Heart Your Heart (MHYH) Project, as well as other buy-in from places like Hamilton County, Indiana’s Coroner’s Office (and many other outfits that have bought-in) have been instrumental in collecting used pacemakers, refurbishing them through a meticulous process, and distributing them to patients in low- and middle-income countries who otherwise could not afford such devices. This initiative not only provides a second life to the pacemakers but also offers a new lease on life to recipients suffering from various heart issues . Clinical trials have shown that reconditioned pacemakers, when properly processed, have comparable safety profiles to new devices, with similar rates of infection and device failure.
Despite all of these promising developments, pacemaker recycling remains a novel and somewhat controversial practice. Regulatory bodies like the U.S. Food and Drug Administration (FDA) have historically been cautious, citing concerns over device integrity and patient safety. However, the growing body of evidence supporting the efficacy and safety of reconditioned pacemakers is prompting a reevaluation of these policies.
So, given the complexities and ethical considerations involved, it is important for individuals to conduct their own research and form informed opinions, emphasis on informed, on the subject. Exploring resources provided by organizations like University of Michigan’s My Heart Your Heart (MHYH) Project can offer valuable insights into the processes, benefits, and challenges associated with pacemaker recycling. Understanding the global impact of such initiatives may also inspire support for policies and programs that promote equitable access to essential medical devices worldwide.
Like I mentioned earlier, the concept of pacemaker recycling can be compared to more familiar medical practices like organ donation. Just as organ donation allows a person’s heart, liver, kidneys, skin, etc. to offer life-saving benefits after death, pacemaker donation extends that same principle of generosity and utility—but through technology. That’s why it’s different. In both cases, something that would otherwise NO LONGER serve a purpose in the donor can provide vital function to someone in critical need. While organ donation has become widely accepted and supported over time, pacemaker reuse is still in its early stages of public awareness and acceptance, reminding us that most medical advances start out as unfamiliar or even controversial. So, I hope this episode has proven to bring awareness to an up-and-coming medical thing!
Similarly, the donation of corneas, bone marrow, or even donated cadavers for research and education all follow the same ethical arc: an initial discomfort followed by broader understanding and, eventually, … support. Pacemaker recycling is currently traveling this arc. It exists in that “middle space” of innovation—where the science is proving itself safe and effective, but public policy and perception are still catching up. And that’s okay. That’s totally fine. If the history of medical science is any guide, this idea too may eventually become normalized and perhaps even expected, especially as worldwide healthcare equity continues to be an important issue.
Medical science, like any other field, evolves through necessity, curiosity, and compassion. What was once considered implausible—such as organ transplants or implantable defibrillators—is now routine. You see what I am saying? New ideas often emerge on the margins, driven by a combination of technological capability and human need. Pacemaker recycling is a clear example of this: a creative, resourceful solution responding to the stark contrast between medical abundance in wealthy countries and scarcity elsewhere. With time and research, ideas like this often transition from “radical” to “responsible.”
Ultimately, just as with organ donation, the choice to support or participate in pacemaker recycling is a personal one. But it is rooted in the same values: the belief that every life is worth saving, and that the legacy of one person can extend beyond their lifetime in tangible, life-giving ways. As society becomes more comfortable with technological reuse in medical contexts, it is likely that programs like pacemaker recycling will be embraced as one more way to honor life—both in passing and in continuation.
Alrighty, let’s wrap this episode up, shall we? Next week, we’re back to the “celebrity estate planning” type of episode – so, for this episode, I’m going to go dive into Marlon Brando’s estate – Marlon Brando was a popular American actor and as many sources mention, he’s often said to be one of the greatest cinema actors of the 20th century. So yeah, next week is on him, Marlon Brando, so tune in for that next week, Legal Tea Listeners. Talk to you then!
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