Chapter 10 Ethical Issues in First-time
Organ Surgeries: The First Heart
Transplant, Artificial Heart; the First
Face, Hand, and Uterine Transplants
Discuss the first human heart transplant that was carried out by Christiaan Barnard. What were
the findings from this transplant? - Aanswer-Barnard was a South African surgeon who
transplanted Washy's heart without regarding the immune system's potential rejection of the
transplant. Washy ended up living for 18 days before the pneumonia from the
immunosuppressants killed him. The findings from this transplant were that the biggest barriers
to transplanting successfully are immune rejections and infection. Immunosuppressants don't
necessarily work as well as Barnard thought because they allow other pathogens to rise in the
body without challenge.
Why was it awkward for Christiaan Barnard to ask Edward Darvall for his daughter's heart? -
Aanswer-Barnard needed Denise to die before he could get her heart, and it is not certain that
every measure to save her life was taken. There was no way of ensuring she was dead. Later, it
was found that Barnard used potassium to stop her heart which is murder.
What is the controversy surrounding whether Christiaan Barnard should have done the heart
transplant in the first place? - Aanswer-No one had discovered how to control rejection.
Physicians like Lower and Shumway had been trying to control it for years by transplanting
hearts into dogs. There was also criticism that Barnard's transplant was unethical and
grandstanding, doing it just for the fame.
Was Christiaan Barnard glorified for conducting the first heart transplant at the cost of other
great heart surgeons who laid the foundation? - Aanswer-Yes. Barnard became a celebrity
which got to his head, corrupting him, despite putting Washy though legitimate suffering. In the
Republic, Plato says that when luck comes, character is revealed. Barnard's character is bad.
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? -
Aanswer-Barnard needed to fight Washy's body's rejection of the transplant, so an increase of
immunosuppressants are needed. However, this could lead to an increase in picking up
infections without an immune system prepared to combat it. This is what happened as one issue
was created by treating another one. This was not ethical because Washy's life was risked,
countering the idea of first doing no harm. But, it could be argued that it was ethical because
flushing the body with immunosuppressants gave Washy the greatest chance of survival.
Did Barnard go too far in treating Washkansky against his will? What is the best example to
illustrates that? - Aanswer-Yes. Washy did not give consent to all that Barnard did. By the end
of his life, Washy had lost the will to live, which was not honored by Barnard. The best example
of this is the placing of the respirator despite Washy explicitly saying he did not want it. Washy
resisted it, despite extreme weakness, but never talked again.
Organ Surgeries: The First Heart
Transplant, Artificial Heart; the First
Face, Hand, and Uterine Transplants
Discuss the first human heart transplant that was carried out by Christiaan Barnard. What were
the findings from this transplant? - Aanswer-Barnard was a South African surgeon who
transplanted Washy's heart without regarding the immune system's potential rejection of the
transplant. Washy ended up living for 18 days before the pneumonia from the
immunosuppressants killed him. The findings from this transplant were that the biggest barriers
to transplanting successfully are immune rejections and infection. Immunosuppressants don't
necessarily work as well as Barnard thought because they allow other pathogens to rise in the
body without challenge.
Why was it awkward for Christiaan Barnard to ask Edward Darvall for his daughter's heart? -
Aanswer-Barnard needed Denise to die before he could get her heart, and it is not certain that
every measure to save her life was taken. There was no way of ensuring she was dead. Later, it
was found that Barnard used potassium to stop her heart which is murder.
What is the controversy surrounding whether Christiaan Barnard should have done the heart
transplant in the first place? - Aanswer-No one had discovered how to control rejection.
Physicians like Lower and Shumway had been trying to control it for years by transplanting
hearts into dogs. There was also criticism that Barnard's transplant was unethical and
grandstanding, doing it just for the fame.
Was Christiaan Barnard glorified for conducting the first heart transplant at the cost of other
great heart surgeons who laid the foundation? - Aanswer-Yes. Barnard became a celebrity
which got to his head, corrupting him, despite putting Washy though legitimate suffering. In the
Republic, Plato says that when luck comes, character is revealed. Barnard's character is bad.
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? -
Aanswer-Barnard needed to fight Washy's body's rejection of the transplant, so an increase of
immunosuppressants are needed. However, this could lead to an increase in picking up
infections without an immune system prepared to combat it. This is what happened as one issue
was created by treating another one. This was not ethical because Washy's life was risked,
countering the idea of first doing no harm. But, it could be argued that it was ethical because
flushing the body with immunosuppressants gave Washy the greatest chance of survival.
Did Barnard go too far in treating Washkansky against his will? What is the best example to
illustrates that? - Aanswer-Yes. Washy did not give consent to all that Barnard did. By the end
of his life, Washy had lost the will to live, which was not honored by Barnard. The best example
of this is the placing of the respirator despite Washy explicitly saying he did not want it. Washy
resisted it, despite extreme weakness, but never talked again.
