Bioethics Chapter 10

Discuss the first human heart transplant that was carried out by Christiaan Barnard. What were the findings from this transplant?

During this time, Barnard was instructed to only transplant kidneys while surgeons overcame the problem of immune rejection. However, Barnard secretly tried to transplant a human heart. Denise Ann Darvall was hit by a speeding vehicle, which led to her death. Her father was then asked if he would allow his daughter’s heart to be used to save the transplantee (Louis Washykansky). Initially, the surgery was a success and it was looking like Washy could soon go home, but symptoms of rejection started, and he had to be placed on a respirator, where he never spoke again. The findings showed that Washy had bilateral pneumonia, and his symptoms were too severe to overcome as Barnard thought that immunosuppressants would suppress the growth of organisms, but it did the opposite.

Why was it awkward for Christiaan Barnard to ask Edward Darvall for his daughter’s Heart?

He was asking a man who just lost his daughter if he would allow her heart to be given to someone else.

What is the controversy surrounding whether Christiaan Barnard should have done the heart transplant in the first place?

He was inexperienced, and surgeons were still figuring out how to properly do heart transplants without rejection.

Was Christiaan Barnard glorified for conducting the first heart transplant at the cost of other great heart surgeons who laid the foundation?

Yes

In treating Washkansky, what trade-off existed between fighting rejection and fighting infection? Was it ethical on Barnard’s part to risk Washkansky’s death and wait for a definitive diagnosis?

The treatment for rejection weakened the body’s immune defense. Not necessarily. Barnard appeared to be making guesses as to what was going on, but it was at the expense of Washy’s life.

Did Barnard go too far in treating Washkansky against his will? What is the best example to illustrates that?

Yes. Washy stated how he was opposed to further treatments because the pain he had gone through had brought him to his wit’s end.

How did Robert Tools fare with the Abiomed artificial heart? What was the essential problem of titanium artificial hearts?

He lived 151 days with the heart. Living human tissue is always going to be opposed to plastic materials.

Who is Dirk van Zyl, and how long did he live with his transplanted heart? How do you think he feels toward Christian Barnard?

Barnard’s sixth heart transplant patient who was the longest living transplant recipient at 23 years. Gratitude for the medical miracle Barnard provided him with.

In what way was Barney Clark a bad candidate to receive the first Jarvik-7? What kind of patient would have been an ideal candidate?

It was too late for Clark and his lungs because the effects of smoking were irreversible by the time he stopped smoking. Someone younger and stronger.

What problems developed while implanting the Jarvik-7 in Barney Clark?

The Jarvik-7 left ventricle did not pump blood, so DeVries risked a possible stroke by opening the ventricle by hand.

Why was there a trade-off in treating Barney Clark’s medical problems?

Clark began developing “pump head,” which was cognitive impairment after a major heart surgery, alongside seizures and small strokes.

How long did Barney Clark live? What did The New York Times say about how long he “was dying”?

112 days. That he was dying for 112 days.

Why did most reporters not understand the problem of post-transplant psychosis and a low quality of life?

The hospital was misrepresenting the true experiences and suffering of the patients through heavily edited videos

After implanting the Jarvik-7, what were the problems faced by William Schroeder and Jake Burcham with regard to the quality of life?

Both patients had a diminished quality of life with grave physical and psychological effects. The hospital was also misrepresenting their states, watering down their daily suffering.

Who received the first hand transplant, and where was it performed? What were the unexpected problems with compliance by the patient?

How did the case end?

Who was the first American patient to get a hand transplant?

How did the transplant affect him or her?

Approximately how many hand transplants have now been performed in the world?

Clint Hallam, and it was performed in France. Hallam demanded that Dubernard amputate his transplanted hand because he felt pain and had no normal feeling in it. Hallam did not take antirejection drugs or attend physical therapy.

Matthew Scott. Scott began to feel cold and heat in his palm, and soon gained normal mobility in it. 85.

What was the criterion used to declare Denise Darvall brain-dead? Why did Denise’s heart stop beating?

She was declared dead after her heart stopped beating. Denise was not declared dead by the whole-body standard. Barnard gave her potassium to speed up the process.

How did Clark’s case symbolize controversies about the quality of life for heart transplant recipients, such as the definition of quality of life, clots, and the quality of heart valves?

Although he essentially had a new heart, Clark’s quality of life deteriorated due to the continued treatment she had to receive and complications with the heart. The blood clots were triggered by the plastic heart, so he had to live with it for the rest of his life, and the Jarvik-7 had initial issues with one of the valves not pumping blood, so when the issues progressed and Clark had to keep getting surgery, his health deteriorated as he suffered from strokes and seizures.

Medicine almost uniformly has judged that artificial hearts are not cost-effective. Should society still encourage the use of artificial hearts or promote a healthier lifestyle?

Promote healthier lifestyles. Artificial hearts are proven to not be sustainable due to rejections, and overall complications with the heart. So if someone has the chance to pursue a healthier lifestyle over surgery, they should.

How did Jarvik and DeVries fare after Barney Clark’s death?

They both had public backlash.

Describe the cases of Jean-Michel Dubernard and Maria Siemionow. Were their

transplants successful?

Dubernard performed a face transplant on Isabelle Dinoire, a mother whose face was left disfigured after her dog attacked her.

Siemionow performed the first American face transplant on Connie Culp who was shot in the face. She went on TV where she was able to speak well and was left with a decent appearance.