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

the procedure.

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

the most.

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

society.