Peer-reviewed article
The total artificial heart. An ethics perspective on current clinical research and deployment.
The development of the total artificial heart (TAH) as a support before cardiac transplantation and as a possible permanent prosthesis has generated intense debate. The social commitment to TAH research entails immense health care costs…
The development of the total artificial heart (TAH) as a support before cardiac transplantation and as a possible permanent prosthesis has generated intense debate. The social commitment to TAH research entails immense health care costs because of the cost of the implant itself and also because of the large number of patients whose interests impel the research. The deployment of the pre-transplant TAH during the current shortage of donor hearts means that the TAH creates its own incentive as a way to compete in an expanded pool of donor heart candidates. Policies to address the orderly deployment and costs of the pretransplant TAH are needed. Research design and current pre-transplant clinical applications require careful consideration of planning for the termination of TAH support for severely injured but not brain dead patients.
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About the author
John D. Lantos is a pediatrician and bioethicist writing on AI in medicine, neonatal intensive care, and end-of-life decisions. His essays appear in JAMA, JAMA Pediatrics, the Hastings Center Report, the New England Journal of Medicine, and Aeon. Read more about John.