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No. 5
Spring 1932


No. 107
Spring 1949


Autumn 1967

No. 164
Spring/
Summer 1968



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SOME THOUGHTS ON HEART TRANSPLANTS

I consider heart transplants to be very important, because not only are they a feat of medical science, but they also raise a great many other issues.

So far there have been quite a number of heart transplants in America, South Africa, France, and the British Isles. One man has now completely recovered from such an operation, and is driving his car, as he says, "in response to the people who said I would never live an ordinary life again." None of the others have survived, except the patient of the British Isles, who, five days after his operation, and who is still alive, having drunk some sherry, talked to his wife, taken solid food, and been allowed to stand up. So what chances of survival are there in these complicated operations ? One in five ? One in ten ? I do not suppose this really bothers the man with a fatal heart disease.

But what of the heart donor's relatives ? How can then really be sure the donor was dead? Death used to be defined as when the heart stopped beating. Is that no longer the case ? If a man has electrical impulses passing along his nervous systems he is said to be alive, yet how can the British surgeons say they were "quite satisfied" that the donor was dead, when they admit he still had electrical impulses passing to his brain ?

Heart transplants involve a number of problems other than surgery, in fact I would say that the surgery is fairly minor compared with the questions that need to be answered. Death has to be re-defined - how is this going to be done, and by whom? The donor for Dr. Philip Blaiberg had a brain haemorrhage, which is dangerous, and yet he was moved from hospital to hospital, despite the fact that he should not have been moved at all, subsequently there was the final movement to the hospital where preparations for the operations were being made, before he was dead. The moving about certainly didn't help him to live, and did it really send him on the road to death, or was death inevitable anyway ? It is difficult to say.

Another problem that needs looking into is whether "the man with the new heart" suffers from any psychological effects. Philip Blaiberg does not seem to do so, but these could be hidden deep in his subconscious, and perhaps will show later in life, or could be suppressed forever. It is too early to say about the British patient.

One of the major problems at the moment is, I think, that of competition. America rushes on, determined to get a heart transplant patient to live; France fails twice, perhaps because the French surgeons were not ready, and did not have enough knowledge, but were trying to get a good start in the Heart Transplant race. England ? Who knows ? It is rather early to say. Meanwhile, Doctor Barnard may sit back smirking at his success, thinking about the trouble other people are having, and announcing to the press that he intends to do a hundred transplants before he retires. To me this statement means he was doing the transplants for the honour, working to win the title of "the man of a hundred hearts, as I think many newspapers would put it. But it could be that Doctor Barnard genuinely wanted to do these many operations before he retired because he felt strongly about human lives, he may have felt he must try to save as many as he could, before retiring, although he could probably retire quite early and live in comfort for the rest of his life.

Whatever the answers to these questions, somebody has got to sit down and think about them hard, to try to solve the problems brought up by heart transplantations.

Charlotte Kent.

 

We are rapidly approaching the time when we will be able to exchange all the parts of the body or so it seems. In recent weeks we have had a startling advancement in medical science, with a first-time success in London of a heart transplant and a less successful lung transplant in Edinburgh. Kidney transplants have been successful in England for the last two years. We see a picture of a future where we can replace all parts of the bode.

Some people think that if you have a heart transplant your personality changes. It seems that this belief is unfounded since the heart is only an organ causing the blood to circulate. What is more frightening is the prospect of brain transplants where your personality would change. With brain transplants one must think in terms of heart transplants. Head transplants have been successfully carried out in dogs.

In Parliament at the moment there is a Private Member's Bill being brought in by Sir Gerald Nabarro which will allow doctors to take out a patient's kidneys without the consent of any relatives. The doctor will not be able to take the kidneys out if the patient has specifically said "No. Some people want this bill extended to include all the organs.

But will the old legal formula *qui tacet consentire apply to this new legislation?

 *Silence gives consent.

 Richard Czihorra.

 

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