The Total Artificial Heart
An Ethics Perspective on Current Clinical Research and Deployment
Precent progress with the total artificial heart (TAH) has captured public interest, subjected preliminary human trials to unprecedented scrutiny, and fueled an intense debate among ethicists, policy. Investment in TAH research continues to yield insights into cardiovascular physiology and clinical problems such as anticoagulation which have wider clinical utility. TAH research is also a potent symbol of hope and social commitment to patients with heart disease and their families, much like chemotherapy research is for those dying of presently incurable malignancies. buy actos 30mg
Quality of Life
Critics argue that the poor quality of life while “connected to a 400 pound driveshaft” makes further TAH development unethical. This echoes a 1973 government study which feared that the TAH would leave patients gravely impaired—just well enough to want the device, but not well enough to avoid substantially burdening others. Patients for pre-transplant bridges as well as for permanent implantation trials have evidently favorably weighed the TAHs benefits against its burdens. The decision to forego the TAH, either at the bedside of a single patient or as a matter of public policy, because of a clinical assessment of quality of life, may reflect prejudicial views of disabled persons. This argument against development of the TAH would use the quality of life afforded by current prototype devices to preempt the development of a device that will offer a better quality of life.
It is argued that modest support for TAH develop-merit should stop because the eventual costs of TAH deployment are unbearable. This view assumes that the TAH would be less desirable than other costly, but established treatments currently supported by private or public funding. Adherents of this position conclude that TAH development should be aborted to prevent a successful TAH from entering the democratic arena which would be unable to resist the appeal of a dramatic new technology.