Untitled Essay, Research Paper
Artificial Heart Devices In its never ending pursuit of advancement, science has
reached a crucial biotechnological plateau, the creation of artificial organs.
Such a concept may seem easy to comprehend until one considers the vast knowledge
required to provide a functional substitute for one of nature’s creations.
One then realizes the true immensity of this breakthrough. Since ancient
times, humans have viewed the heart as more than just a physical part of
the body. It has been thought the seat of the soul, the source of emotion,
and the center of each individual’s existence. For many years, doctors
and researchers left the heart untouched because they thought it was too
delicate, too crucial to withstand the rigors of surgery. However, the innate
human desire to achieve brought about the invention of the artificial heart.
The potential for such inventions are enormous. According to the American
Heart Association, there are between 16,000 and 40,000 possible recipients
of artificial heart devices under the age of sixty-five. If perfected, it
would enable us to save thousands of human lives.
In considering the full impact of artificial heart devices
on society, we must not narrow our thinking to include only the beneficial
possibilities. There exist moral, ethical, and economic factors that accompany
these new innovations to humanity. Who will receive these brilliant inventions?
Obviously not all of the patients will get transplants, so selection criteria
must be established. The high price of artificial heart devices and their
implantation will eliminate some candidates. Unfortunately, this is not fair.
The rich, in essence, can buy life, whereas the poor are abandoned to die
in a diseased state. A thorough analysis of the implications of the implantation
of such devices reveals not only selection and economic consideration, but
mortality and ethics as well. Many contest that it is simply wrong to tamper
with the ways and creations of nature. By prolonging life through unnatural
means were are defeating natures foremost tenet of the “survival of the fittest.”
We are preserving the weaker gene pools and contributing to the deterioration
of the human species. These and other considerations play a vital role in
determining the artificial transplants actual benefit to the contemporary
world and the world of tomorrow. A full-scale incorporation of the artificial
heart devices technology into the medical world could have serious consequences,
all of which must be considered before such a rash step is taken.
Artificial heart devices are indeed a biotechnical wonder. Although they
are not yet perfected for permanent implantation, they are the most reliable
substitutes for bad heart parts until other functional, transplantables can
be located. The Jarvik-7 was the first artificial device heart which was
created by Symbion Incorporated. This system was used to replace the heart
of Dr. Barney Clark, the first artificial heart patient. The device lasted
for one-hundred and twelve days before Mr. Clark sank into an agony of
complications and died. The Jarvik-7 was implanted four more times to replace
failing hearts, with similar results, before the federal authorities halted
Other devices have made progress since the Jarvik-7. One of the more successful
inventions is the left ventricle assist device (LAVD). This device incorporates
a host of hard won technological advances. Perhaps the most important is
its “bio-compatible” materials, which have allowed the LAVD to function without
problems for well over a year in a patient’s body. The LAVD has been implanted
in more than seven hundred people for up to seventeen months, as they have
awaited human heart transplants(Stipp 38).
It is difficult to fathom the great scientific ingenuity that was required
to develop these devices. However, we must not be blinded from seeing the
whole picture. In assuming its role as a boost to humanity, these inventions
bring many concerns. The issue of selecting patients for implantation is
an important one. There are three alternatives for selecting patients who
should have priority to receive artificial heart devices. The first decision-
based medical criteria, which seems to make the most sense. This method is
meant to choose the ideal patient; the patient who can reap the most benefits
not only for himself, but for researchers. Therefore, researchers look for
a subject who will yield the information sought and thus produce the gains
of new knowledge and therapies. In choosing a subject in this manner, researchers
are governed by a principle of nonmaleficence, which means they can do no
harm solely in order to further the experimental aspect of the operation.
This rule prevents the “mad scientist” mentality from taking hold in experimental
research. As Claude Bernard, the father of experimental research stated:
“The principle of medical mortality consists in never performing on a man
an experiment which might be harmful to him in any extent, though the result
might be highly advantageous to science and to the health of others”(Holland
14). It would also seem logical that the decision be based on medical need,
but practicality rules these out since many candidates have roughly equal
needs for artificial heart devices.
A second method of selecting patients is ranking them
based on their “social worth.” This method would reward those who have benefited
the community and demonstrated dedicated social productivity. After all,
if someone has helped society, he or she is entitled to their fair return.
Although this alternative is based on fair morals, it may meet the problem
of social value. Two people might be valuable to society completely different
ways, and which one is to receive priority. This also contradicts the American
principle of the equality of all human beings, regardless of social
contributions. The third method, random selection, may be used to select
candidates with equivalent needs for artificial heart devices. Random selection
may be accomplished either by lottery or by queuing, which is exemplified
by the adage “first come first served.” This method seems fair until one
considers that one has led criminal lives or have done poorly by society
may come out on top. This is definitely not justice. So how should we select
patients for implantation’s of artificial heart devices? Perhaps the
selection process cannot be simply narrowed down to a single criterion, but
combinations of several could be used to determine who deserves these transplants
As depicted above, the selection of patients is a serious
issue in the realm of artificial heart devices. Once a candidate has finally
been chosen, however, how is he or she to finance such an elaborate surgical
operation? The price for an implant of such complexity is extremely high.
The estimated price for an LAVD is about fifty- thousand dollars(Stipp 41).
This figure does not include hospital bills for the care and the board of
the patient. This is an extravagant amount which most people simply cannot
pay. Perfection of artificial heart devices will naturally lead to a widespread
demand for the inventions, but still many will be unable to afford it. A
total incorporation of heart transplants into the field of medicine would
force insurance companies to expand their coverage. The population would
benefit from this expansion, as would the insurance companies, since they
would surely sell more health insurance plans because of the increased demand.
Some believe that the implantation of artificial heart devices will strengthen
the case for the national health insurance.
Another question to be considered is whether or not it
is worth the high cost to have the operation. The common response is to say
that a price cannot be put on life, but can we honestly say it is worth thousands
of dollars to prolong someone’s life for an indefinite length of time?
The price may be indeed be too high to postpone what might be a destined
fatality. One could spend fifty thousand dollars to have an implant placed
in his eighty year-old father’s chest, only to witness the death a month
later. After all, it is natural for people to die. We all have a destiny
which looms over us, over which we have no control. The patient himself must
ask if it is worth the money to prolong his life, but to have his quality
of health diminish greatly. With today’s technology, an artificial heart
recipient’s mental state may become very distraught. Thoughts of death
hover over his head, as he can never predict when the device may fail.
The use of artificial heart devices as a viable technique
will undoubtedly raise many legal and ethical questions. Before completing
the discussion of artificial heart technology, these questions must be addressed.
An important requirement for the surgical operation is that the surgeon must
receive the informed consent of the patient. The patient must be aware of
the nature of the operation and its dangers, and still be willing to go through
with the procedure. However, a real life scenario may occur which does not
allow for the patients consent. For example, suppose a patient is on the
operating table undergoing bypass surgery and sudden complications occur
involving heart failure. The doctor uses his best judgment to find the only
way to save the patient’s life; he inserts an artificial heart device. The
physician may be endangering the patient’s life by removing the natural
heart and inserting an artificial device. However, the transplant without
informed consent should be considered as an emergency medical operation.
Possibly the patient’s family should be the consenting party. This sounds
like a suitable solution, but factors such as greed may interfere with the
family’s decision. If the patient has a large life insurance plan, his
beneficiaries may consent to the artificial implant since it would greatly
improve the risk to the patient’s life.
The perfection of artificial devices for the heart will
definitely have a great impact on society. This can be classified in two
major ways: financial problems and population problems. Of course, increased
use of artificial heart devices in medicine is going to increase the financial
burden on society. The potential gains will be substantial when the lives
of many productive individuals can be saved. The extent of the financial
burden depends largely upon the number of patients who benefit from the
artificial valve, the availability of the device, and improvements in its
efficiency and dependability. In the long run, worldwide utility of the
artificial valve technology would increase the world population. Overpopulation
is already the root of many of the world’s crises.
The many debates concerning artificial heart implantation as a medical technique
each have their own significance, and each deserves thorough consideration.
Before we rush headlong into complete employment of the devices in medicine,
we must evaluate the moral, social, ethical, arguments. Hopefully we can
reach a decision that blends all of the aforementioned considerations into
a harmonious existence, working to the maximum benefit of