Cardiologist discusses ethical issues in artificial heart support

Margaret Peppiatt
Staff Writer

A doctor discussed the ethical principles involved in deciding to discontinue artificial heart support in an academic lecture Friday in the Gentile Gallery.

John A. Schirger, director of the Heart Failure Clinic at Trinity Health System and past president of the Catholic Medical Association, gave the talk to mark the beginning of his new position as a visiting professor in ethics and medicine at the Center for Bioethics at Franciscan University of Steubenville.

Schirger first talked about the causes and symptoms of heart failure, specifically left-sided systolic heart failure caused by a reduced squeezing function of the heart.

Patients who do not qualify for a heart transplant sometimes can be treated with an implanted left ventricular assist device (LVAD).

Schirger presented the case of a 70-year-old man with an LVAD who suffered bleeding in the brain and residual cognitive dysfunction from a fall. The man had no other options for receiving long-term care, so Schirger questioned whether it was ethical to turn off the LVAD.

The doctor then examined the issue from multiple angles, discussing various principles of healthcare ethics such as the autonomy of the patient to make their own decisions.

“Autonomy takes pride of place in modern bioethics, but it’s important to keep in mind: are we talking about autonomy for the good … or are we talking about a pure expressive individualism which decides what the good is rather than trying to discern the good as a gift?” Schirger said.

After looking at personalism and several encyclicals by Pope St. John Paul II, Schirger returned to the case study of the 70-year-old man.

While it was likely ethical to turn off the LVAD, Schirger said it was “one example of how there need to be other options within our health system.”

The talk was sponsored by the Center for Bioethics.


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