Artificial Heart Devices 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.