THE DEBATE OVER THE ARTIFICIAL HEART

Here are the principal arguments over whether the artificial heart should be used as a permanent replacement, as advocated by Dr. William DeVries:

AGAINST:

- Strokes, clotting, bleeding and other problems in patients suggest the Jarvik 7 remains too dangerous, even for dying patients.

- The therapy is too expensive and represents a poor allocation of U.S. medical resources.

- The device should go back to the lab and not be used in humans until it can be reconstructed of materials less offensive to human blood.

- The device should only be used in humans as a temporary “bridge” to transplantation.

- The money would be better spent exploring ways to prevent heart disease.

- The research should not be done by a private institution like Humana, where the profit motive might conflict with scientific objectivity.

- It is impossible for a dying patient to provide the kind of “informed consent” needed to justify subjecting him to such an extraordinary procedure.

IN FAVOR:

- About 30,000 people a year who are either ineligible for human heart transplant or for whom no human heart can be found die of heart disease.

- The artificial heart patients’ quality of life may not have been what they or DeVries had hoped, but each gained some period of what DeVries calls “meaningful life.”

- Recurrent failure has been the norm in early stages of emerging medical techniques, such as heart transplantation and kidney dialysis.

- Questions about the future cost to society versus the public good cannot be answered until clinical trials have determined whether the device can work.

- Federal regulation, peer review and public scrutiny are too thorough to permit a private institution to distort research in the interest of profit.

- A patient’s consent may be granted under the duress of impending death, but no one has the right to usurp that choice.