An ethics consultation case is presented in which a hospice patient wished to deactivate his Cardiovascular Implantable Electronic Device (CIED), specifically an implantable cardioverter-defibrillator, at the end of life to prevent the prolongation of the dying. The consultants developed an ethical analysis supporting the deactivation of the pacemaker based on authoritative literature and moral reasoning. The consultants’ recommendations to deactivate the pacemaker were ultimately rejected by the medical team based on an alternative assessment which concluded the patient is suicidal, doubts based on the consultants not being physicians, and the healthcare professionals’ sense that deactivating a pacemaker is different from withdrawing other forms of life-sustaining treatment at the end of life. Professional reflections by the consultants and lessons learned are discussed.