Artificial Heart: Balancing Ethics, Policy, and Medical Research

Our archive is a collection of newspaper and magazine photographs and articles describing the development and first transplant of the artificial heart by Dr. Denton Cooley. We hope to focus on the aspect of following institutional and governmental rules and regulations in regards to conducting clinical trials and performing experimental procedures.

We have chosen to target our project at students studying public health policy. For example, Rice has a program of studies dedicated to public health management, which can be found here. We believe our archive would benefit these students by providing information about the multifaceted nature of public health policy. We hope our archive can reveal different perspectives on how to balance ethics, policy, and research to provide the most supportive environment for producing advancements in medicine.

Intersection of medicine and law (cambridgemedicine.wordpress.com)

Our project is important because the government and medical institutions play a large role in deciding what types of medical research should be funded and what types of medical research should be discontinued or hindered. Dr. Denton Cooley was able to successfully perform the first artificial heart transplant by disregarding federal regulations and hiding his research from his colleagues at the Baylor College of Medicine. Did his success justify his disregard for protocol? Were his actions ethical from a philosophical perspective? How can the government make policy that ensures ethical practice but does not hinder important medical research that can be used to improve public health practices? These are questions that our archive provides perspective into and can hopefully inspire policy studies majors.

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Medical World News article about Dr. Cooley’s unauthorized transplant (Image taken at McGovern Historical Center)

We chose to present our archive in the form of an informative website because students will be able to have direct access to primary sources taking the form of videos, photographs, and articles. A website is the most accessible for students and allows students to reference the material easily during their studies.

We will need to conduct further research into the atmosphere of government regulation of medical research during the time that Dr. Cooley performed his transplant, by analyzing the material in our archive. We can also research how government regulation either protects public health or hinders medical research today by consulting with medical practitioners and professors and finding journal articles written about the topic. We can research how our archive can fit into the curriculum of policy studies majors by talking to current majors and professors.

 

Proposal for the Artificial Heart: When Does Regulation Become Impeding?

The subject of our archive—the feud and controversy surrounding the development and eventual transplantation of the artificial heart—presents the relationship between regulations and scientific advancements, made even more complex with the factors of personal ambition and ethical dilemmas. We will be focusing on the controversial feud between Dr. Cooley, the first heart surgeon to successfully transplant an artificial heart, and Dr. DeBakey, who developed the artificial heart.

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The feud between Dr. Cooley and Dr. Debakey spanned a period of 40 years. (NYTimes)

Our archive will explore an instance when disregarding regulations advanced medical research—Dr. Cooley succeeded in transplanting the first artificial heart, but his motives and methods of doing so are questionable. We will also discuss the implications and various perspectives involved (some may argue that regulations are necessary to essentially, keep doctors and researchers “in check” because they have to follow specific guidelines before their research can be applied clinically. Others say regulations provide a sort of constant baseline to which discoveries must adhere to).

Because regulations are an issue that doctors and other medicinal practitioners have frequently run into (and thus, a project showing how regulations can prevent advancements will not change their perspective), our target audience will be undergraduate students interested in health policy. By learning about the complex association of regulations and advancements, these students can apply this knowledge as they begin to make policy/regulations.

We plan to use a WordPress website to concisely discuss the perspectives involved; each page will focus on a specific perspective (for example, one page will be dedicated to the benefits of regulations). For the perspective of scientific researchers, we may interview Rice professors, who can offer insight to what it is like to work in the competitive scientific field. Through the Fondren library database, we will conduct outside research government regulation of medicine (ex. FDA regulation) and the reasoning behind such regulation. In order to target our audience most effectively, we can look into current health policy programs at the undergraduate level (ex. Policy Studies major at Rice) and at the professional level (ex. Baylor College of Medicine’s Health Policy Program); this will be done through Rice’s and Baylor’s websites, respectively.

Ultimately, our project is meant to raise questions about the role of regulation in scientific research, all while considering the aspects of competition/personal gain and the duty of physicians/researchers to “do no harm.”

References:

  1. “The Feud” (http://www.nytimes.com/2007/11/27/health/27docs.html)

Regaining Control of Our Future

To frame the zombie epidemic as a “world war,” we acknowledge that there are two sides to this conflict, and that their respective goals clash with each other. While humans are concerned with preserving their race, the zombies are a unified unit waging total war, driven by their need to feed. In this situation, defense does not offer a permanent solution: we are only holding off the zombie forces temporarily, rather than decisively stopping the zombie epidemic. In fact, we grow weaker because every person we lose either dies, or becomes a zombie (and then dies again). The zombie population is made even more dangerous because they do not abide by the basic restrictions of being “bred, fed, and led” (Brooks 271).

Thus, if I were a head of state in World War Z, I would vote to go on the offensive, and attack the zombies with military forces. Because the zombie population is not held together by morale, it does not have a “maximum emotional psychology breaking point” (Brooks 273)—but the human population does. To circumvent this disadvantage, humans need to rally forces and eliminate the zombies methodically. Rather than wait for the zombies to slowly infect us all, we are now actively seeking them out and regaining control over the situation.

From a tactical standpoint, the army’s position and the amount of ammunition are crucial. A productive battle position is also a simple one: people are “massed in a straight line, two ranks: one active, one reserve […] Theoretically, with everyone either firing or reloading, we could keep Zack falling as long as the ammo held out” (Brooks 277). With enough resources, we not only outlast the zombies, but also ensure their defeat. By gradually killing each zombie and seeing concrete results, we also build morale, a crucial element to our success because we are fighting against enemies who do not need morale to keep going.

However, this approach raises questions about ethics. Although some argue that attacking the zombies is a death sentence, those who go into battle are aware that they may not make it out alive. Each person is “already a veteran in some sense” because “anyone who couldn’t roll wouldn’t have made it this far in the first place” (Brooks 276). A new, more experienced team can then be assembled, promoting both effectiveness and a sense of solidarity.

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To successfully deal with the zombie crisis, humans need to work as a team.

If we think of the zombie crisis as an epidemic, it suggests that an “infection” is spreading. “Infection” is hardly a tangible foe, which makes it difficult for humans to fight together against this common enemy. If we think about the zombie crisis as a war, however, it implies that humans are fighting against their enemies—the zombies—and we are armed with “heart, instinctive, initiative, everything that makes us us” (Brooks 308). In the narrator’s interview with Todd Wainio, we see the impact this sort of spirit and morale-building can have. He states that after the battle (in which the plan to attack was implemented), “[i]t was different vibe, one-eighty from two days ago. I couldn’t really put a finger on what I was feeling, maybe it was what the president said about ‘reclaiming our future.’ I just knew I felt good, better than I had the entire war” (Brooks 282). The “war” Wainio describes here consisted of humans defending against zombies and fighting a losing battle. But now, we are waging a new kind of war—this time, with intention to actively eliminate our enemies. The concept of “reclaiming our future” is abstract, but by unifying the human population, it motivates us to keep fighting so that the human race has a future.

Resources:

  1. Brooks, Max. World War Z: An Oral History of the Zombie War. New York: Crown, 2006. Print.
  2. Photo of teamwork (http://blog.vihaanworld.com/post/team-building)

 

Archives: Great for Explorative Research

Before last Thursday I had some idea of how an archive might function. In my mind an archive functioned much like a museum of documents: a place to observe ancient written documents from behind a glass cover. Don’t get me wrong, museums can be exciting. But they’re also inaccessible. Preserved material culture can’t be engaged as in a discussion.

What surprised me about my visit to the McGovern Historical Center, and something I learned about archives in general, is that the material at an archive is meant to be engaged. We were free to carefully flip through and discover on our own (information was less presented than made available for exploration). Another thing that differentiates this archive from a museum is that important new interpretations and discoveries can happen at an archive. The archivists expect and encourage visitors to use and expand upon documents in the collection.

President Obama visits Hiroshima (Image from http://www.cnn.com)

The McGovern Center holds a large collection from the Texas Medical Center documenting the intersection of public health with other areas of study including ethics, technology, and the practice of medicine. The archivist mentioned in passing that many documents from the Atomic Bomb Casualty Commission are stored at the center. The commission studied the effects of radiation from the dropping of the atomic bombs on Japan during World War 2.

I’ve always been interested in learning more about these bombings than the surface-level discussion provided in my high school history class. I followed up with the archivist, who referred me to a US doctor’s journal documenting his experiences interviewing radiation survivors. The supplementary material exposes important insights on ethics in medicine and institutional pressures that may limit conscientious behavior.

Overall I was very surprised by how engaged I was at the archive, which I found accessible and intriguing. I found the material very pertinent to my interests in ethics and medicine, expanding my resource list for their study.

City of Hiroshima in aftermath of bombing (Image from http://www.dailymail.co.uk)