Artificial heart: the debate goes on.
Earlier this month, artificial hearts were implanted in three people in one week, including one in a woman who received a second artificial heart after a transplant failed. Is the artificial heart a valuable new device that can save the lives of tens of thousands of people in the United States each year? Or is it instead something that will prolong dying and drain precious medical resources?
These questions were debated last week by artificial heart inventor Robert Jarvik of Symbion, Inc., in Salt Lake City, and Daniel Callahan of the Hastings Center, a biomedical-ethics research institute in Hastings-on-Hudson, New York. Their discussion was sponsored by the National Press Club, and occurred the same day a congressional committee held a hearing on the value of the device.
Past experience with the artificial heart, most notably in a Swedish recipient who lived for seven and a half months and during that time was able to climb five flights of stairs, " really showed us that we can achieve a good mobility and a good quality of life," Jarvik said.
But many recipients have suffered strokes and other problems. Only two of the five who received permanent implants are still alive, and both remain in the hospital. "We're not going to create healthy people with long life expectancies," Callahan said. "We're going to create people who are going to be chronically ill."
Of a recent study from the National Heart, Lung, and Blood Institute in Bethesda, Md., estimating that the artificial heart can and 54 months to a person's life, Callahan said, "[That] doesn't seem to me to be terrific."
Answered Jarvik, "It does to me." His estimate is much longer: "I foresee the possibility of maintaining a person for 20 years as a realistic goal." To free recipients from being tehtered to a bulky power source during that time, hs company is working on a battery-powered device worn in a vest, he told SCIENCE NEWS after the meeting. A completely internal power source would have to be nuclear, and such a device is unlikely to be accepted by the public or the medical community, he said.
The value of the artificial heart is a question not just for the potential recipient but for society as a whole, Callahan noted. The National Heart, Lung, and Blood Institute estimated last year that there are 17,000 to 35,000 potential candidates for an artificial heart each year. At a cost of $150,000 per implant, the procedure could add $2.5 billion to $5 billion to the United States' medical bill, the institute determined. "One hates to argue against something that has value for some individuals," Callahan said. But that money could be better spent on health education aimed at prompting behavioral and dietary changes to prevent heart disease, he said.
Jarvik, noting that $3 billion is spent on video games each year, countered that the artificial heart could allow people to remain productive members of society.
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|Date:||Feb 22, 1986|
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