If a pacemaker is discovered after consent for cremation, what is the recommended action?

• A. Do nothing and proceed with cremation
• B. Remove pacemaker without consent
• C. Contact the next of kin for consent to remove the pacemaker
• D. Seek a court order

Answer: (C)

The key issue is safety and authorization when an implanted device is found before cremation. Pacemakers can pose a hazard in the cremation chamber due to the battery and metal components, so removing the device before cremation is required. However, removing a pacemaker requires explicit permission. Cremation consent covers the decision to cremate, but not automatically permission to remove an implanted device after consent has already been given. Therefore, the recommended action is to contact the next of kin to obtain consent to remove the pacemaker. Once they agree, the device can be removed and cremation can proceed safely. If the next of kin cannot be reached or refuses, follow your organization’s procedures, which may include legal steps such as a court order.