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A machine that makes it hard to die


USA/Our latest special report by Toni Clarke and Debra Sherman examines how a new heart pump is revolutionizing heart failure treatment.

Dr Lynne Warner Stevenson, Professor of Medicine at Harvard Medical School, raises a fascinating ethical question about the device, made by Thoratec. “This is one of the ways our technology has moved ahead of our humanity,” she said. “We haven’t had enough experience yet about how to help people die naturally who have a ventricular assist device. And I can tell you, it is difficult to die with one of these things in place. The body does not give up easily when the blood flow is maintained.”

One big advantage: the knotty problem of deciding who, of the thousands of patients who need a heart transplant, actually gets one, has largely been obviated with the introduction of a robotic heart assist device that can be used in thousands of patients with end-stage heart failure.

“It relieves us of the very uncomfortable problem of distributive justice in terms of heart organs and removes what has always been quite a challenging ethical problem,” said Stevenson, who is also the director of Cardiomyopathy and Heart Failure at Brigham and Women’s Hospital in Boston.