Keeping you current

Remembering Barney Clark, Whose Ethically Questionable Heart Transplant Advanced Science

Three decades ago, a dentist agreed to receive the first artificial heart. And then things went downhill

A Jarvik-7 artificial heart in the Smithsonian's collection. (National Museum of American History)
smithsonian.com

Dr. Barney B. Clark was dying.

He was 61, a dentist from Seattle, whose congestive heart failure meant he had trouble walking from bedroom to bathroom, writes Tony Long for Wired. He was so sick, in fact, that he was ineligible for a heart transplant. His last hope, such as it was: the newly FDA-approved Jarvik 7.

The plastic and metal contraption was intended to replace his failing heart and do what it could not. With the understanding that his long-term survival chances were almost zero, Long writes, Clark agreed to undergo the transplant in the interests of science.

On December 2, 1982, Clark became the world’s first recipient of an artificial heart.

He lived for another 112 days, his heart powered by a dishwasher-sized air compressor that he was permanently tethered to, writes Clyde Haberman for the New York Times. In those days, suffering from the infections that made artificial organ transplant such a dicey proposition, he floated in and out of consciousness, Long writes, several times asking to be allowed to die. He had convulsions, kidney failure and memory lapses before his ultimate death, adds Haberman.

After his death, his widow Una Loy said her husband “believed in the artificial-heart concept and wanted to make a contribution,” analyst Ralph Breauer wrote in The New York Times in 1988. In the almost six years between Clark’s death and the article, four more men had received artificial hearts. William J. Schroeder, the longest to survive after transplant, lived for 620 days. “...We must recognize that death is an ethical as well as a medical issue,” Brauer wrote.

Clark died of “circulatory collapse and secondary multiorgan system failure,” a hospital spokesperson told Lawrence K. Altman of the Times. In other words, complications. The heart is a pump, but “... to describe the heart as merely a pump is much like saying that all the cellist Yo-Yo Ma does is drag horsehair across wires,” Haberman writes. It couldn’t be replaced by a simple pneumatic pump, and infection damaged his organs at the same time. The spokesperson described his death as having “dignity,” but to some members of the emerging field of bioethics its circumstances were anything but dignified—or ethical.

The consent form Clark signed was “incomplete, internally inconsistent, and confusing,” History News Network reports one contemporary bioethicist as saying. At 11 pages, the form was “notable more for its length than for its content,” reports the ACLU.

The artificial heart remains a not-yet-attained scientific goal, though Haberman notes that the FDA withdrew approval for the Jarvik-7 in 1990, “citing concerns about the manufacturer’s quality control.” But there are others, some descended from it. Artificial body parts have become more common than they were when Clark received his heart.

For curator Judy Chelnick of the Smithsonian's National Museum of American History, holding a Jarvik-7 in her hands was her first "Smithsonian 'oh wow'" moment, reports Mencahem Wecker for Smithsonian.com. The artificial heart had belonged to, Michael Drummond, the sixth recipient of a Jarvik-7, and the artifact is in the permanent collections of the museum.

From a scientific perspective, it’s hard to call Clark’s experience with the Jarvik-7 a total failure, but on the 34th anniversary of his final act, his death remains shrouded in ethical ambiguity. Currently the closest we are to a fully-functioning artificial heart is the Carmat, but it still has a way to go before artificial hearts become as commonplace as artificial hips.

Tags

Comment on this Story

comments powered by Disqus