Barney Clark and the Jarvik-7 Artificial Heart: Ethics Case
This paper examines the landmark 1982 case of Barney Clark, the first human recipient of the Jarvik-7 mechanical heart, implanted by Dr. William DeVries in Salt Lake City. Drawing primarily on Gregory Pence's analysis in Classic Cases in Medical Ethics, the paper surveys the historical development of artificial heart research, the medical circumstances that led to Clark's surgery, and the many complications he suffered during his 112-day survival. The paper then evaluates the central ethical issues the case raised: the adequacy of informed consent, the reliability of the Jarvik-7 device, Clark's deteriorating capacity to make medical decisions, DeVries's financial conflict of interest, and the broader question of whether prolonging life under such conditions constitutes a meaningful medical success.
- Introduction: The First Artificial Heart Implant: Clark's death after 112 days with Jarvik-7
- Historical Background of Artificial Heart Research: NIH funding, DeBakey, Cooley, and early LVAD development
- Medical Circumstances of Barney Clark's Surgery: Clark's health, device design, and surgical risks
- Surgical Complications and Outcome: Intraoperative failures and Clark's deterioration
- Ethical Issues: Informed Consent and Quality of Life: Consent adequacy, success criteria, and patient autonomy
- Conflict of Interest and the Limits of Objectivity: DeVries's financial stake in Jarvik-7 company
- Later Developments and Ongoing Ethical Questions: Improved devices, animal testing limits, and ethics going forward
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What makes this paper effective
- It grounds ethical analysis in concrete, well-documented facts — device weight, surgical complications, financial arrangements — rather than abstract principles alone.
- The paper presents multiple perspectives (DeVries, DeBakey, Clark himself, critics) and lets them speak in tension with one another, giving the argument genuine depth.
- The concluding analogy comparing Clark's experience to a cancer patient's extended life is an effective rhetorical move that keeps the ethical stakes concrete and human.
Key academic technique demonstrated
The paper demonstrates case-based ethical reasoning: it builds a factual narrative first, then layers ethical critique onto specific events and decisions rather than applying a single abstract framework. This approach, common in bioethics, allows the critique of informed consent, conflicts of interest, and success criteria to emerge organically from the facts of the case.
Structure breakdown
The paper opens with the dramatic facts of Clark's death, then steps back to trace the history of artificial heart research before returning to Clark's specific medical situation. The middle sections analyze surgical complications and ethical failures. The final sections extend the analysis to DeVries's conflict of interest and newer artificial heart technology, ending with a normative claim about what ethics requires of surgeons performing experimental procedures.
Introduction: The First Artificial Heart Implant
In Salt Lake City, Utah, Dr. William DeVries operated on Barney Clark, a dentist from Seattle, to replace his failing heart with a mechanical one. Clark suffered multiple complications — both involving his own body and the functionality of the Jarvik-7 mechanical heart — and after 112 days of extraordinary efforts to keep him alive, his heart was turned off on March 23, 1983, and he died. When he died, the Jarvik-7 heart had beaten 12,912,499 times (Pence).
This medical event raised a number of medical, legal, and ethical issues: Clark's ability to continue making his own medical decisions; the NIH's decision to allow DeVries to use the heart on a human; whether the state of Clark's health following his surgeries justified the extreme measures taken to try to extend his life; and possible conflicts of interest regarding Dr. DeVries.
Historical Background of Artificial Heart Research
Shortly after World War II, two members of Congress who had special interests in medical issues generally — and heart disease in particular — pushed for the government to fund research on the causes and treatments of heart disease (Pence). This research led to a variety of developments in the treatment of life-threatening heart disease. Michael DeBakey developed a left ventricular assist device (LVAD) in the 1960s (Pence). Research on that approach continues to this day. LVADs, by supporting the function of the ventricles, can keep a heart going until a transplant is available.
The National Institutes of Health (NIH) funded the development of artificial hearts from 1964 to 1982, as well as LVADs. During that time they provided $200 million in funds for that research (Pence). DeVries, working with Robert Jarvik — who had previously invented the first devices for hemodialysis to support patients with kidney failure — worked on an artificial heart that would attach to the atria, replace the ventricles, and be pumped by external equipment. The patient would have to be connected by tubes to the external machinery, which weighed 375 pounds and was contained on a rolling cart so the patient could have some mobility (Pence).
Barney Clark was not the first patient caught up in ethical discussions regarding an artificial heart, however. In 1969, a colleague of DeBakey secretly hired some of DeBakey's staff in an attempt to develop his own artificial heart. The patient, Haskell Karp, was supposed to receive a heart transplant — in itself a very new and controversial procedure at the time. Instead, Dr. Denton Cooley implanted his LVAD without permission from the United States Public Health Services committee that reviews medical experiments (Pence). Karp survived, comatose, for three days. It later emerged that Cooley had tested his device on several calves, all of whom died. Cooley repeated the operation on a human two years later with similar results. By comparison, DeVries was working on his artificial heart within the rules established by the medical profession (Pence).
Medical Circumstances of Barney Clark's Surgery
There were serious medical issues involved in the decision to implant the first Jarvik-7 heart into Barney Clark. Clark had not only severe heart disease but severe emphysema as well. He might have been a candidate for a heart-lung transplant, except for his age — 61. The heart-lung transplant program had a cutoff age of 50 (Pence). Medically, it was a difficult decision because of the very real possibility that the surgery itself could kill Clark (Pence).
The Jarvik-7 was designed to replace the lower two chambers of the heart — the left and right ventricles, the parts that do the pumping. It was constructed primarily of plastic, polyurethane, and aluminum, and attached to the atria with Velcro, with one strip of the two-piece system attached to the bottoms of the ventricles. It ran on compressed air provided by the external unit and was connected to the mechanical heart with tubes (Pence).
DeVries had permission from the NIH to proceed under specific guidelines. In addition, the hospital had put strict guidelines in place, requiring, among other things, that the patient be near death (Pence). DeVries technically met the multiple requirements placed on who should receive the first Jarvik-7.
Bibliography
Academy of Achievement. "Willem J. Kolff, M.D., Interview."
Ehrenman, Gayle. 2003. "A Whole New Heart." Mechanical Engineering 5:8, pp. 51–54, Aug.
Pence, Gregory E. "Artificial Hearts: Barney Clark" in Classic Cases in Medical Ethics, 2nd ed.
Simmons, Paul D. 2001. "The Artificial Heart: How Close Are We, and Do We Want to Get There." Journal of Law, Medicine & Ethics, pp. 401+.
Staff writers. "Prolonging Death Is No Triumph." Essential Documents in American History.
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