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<v Speaker>The following is a presentation of the National University Consortium. <v narrator>The human heart mechanically, a simple pump <v narrator>beating 100000 times a day, billions of times in a lifetime.
<v narrator>This center of human life, not just for what it does, but for the symbolism <v narrator>we attach to it. <v narrator>It aches when we miss a loved one, breaks when we lose a lover. <v narrator>Its beat is the symbol of life itself. <v narrator>And now we can replace it. <v narrator>In 1965, a year in which seven hundred twelve thousand Americans died <v narrator>of heart disease. The U.S. Congress made the development of a totally implantable <v narrator>artificial heart, a national goal. <v narrator>It was supposed to take five years and cost 40 to one hundred million dollars. <v narrator>Predictions that have missed by some 13 years and one hundred million dollars
<v narrator>so far, this heart is not totally implantable. <v narrator>The patient must be tethered to the power source. <v narrator>Nevertheless, it is an impressive achievement. <v Chase Peterson, M.D.>Dr. De Vries has been in surgery now for five and a half <v Chase Peterson, M.D.>hours. The patient is doing well at the present time. <v Chase Peterson, M.D.>And I'm pleased to say that it's been now 50 minutes since the patient was off. <v Chase Peterson, M.D.>The heart lung machine, namely the last 50 minutes. <v Chase Peterson, M.D.>The patient has been sustained by his own new heart. <v narrator>Like all technologies, the artificial heart raises questions of cost, <v narrator>benefits and risks, ethical and social questions, questions that require <v narrator>careful consideration in studies known as technology assessments. <v narrator>For if we are to manage the future.
<v narrator>We must anticipate the effects of technology and prepare. <v narrator>With the artificial heart, we haven't done either. <v narrator>Very well. <v narrator>The first artificial heart study was completed in 1966, a time <v narrator>of great technological confidence. <v narrator>If we could launch rockets, surely it would be easy to duplicate a simple blood <v narrator>pump. <v John Bunker, M.D.>In the absence of good data <v John Bunker, M.D.>we've systematically tended <v John Bunker, M.D.>to be optimistic. <v John Bunker, M.D.>In fact, very systematically, it's now been well-documented. <v John Bunker, M.D.>The poorer the evidence on which our evaluations are formed, <v John Bunker, M.D.>the greater the enthusiasm or optimism that we have. <v John Bunker, M.D.>And I am absolutely convinced that <v John Bunker, M.D.>this is the single most important reason for the
<v John Bunker, M.D.>what we assume are what I believe is large <v John Bunker, M.D.>overutilization of medical and surgical procedures, hospitalizations. <v John Bunker, M.D.>Everything we do, I guess it's it's it's understandable. <v narrator>John Bunker has done numerous technology assessments, including one in 1979 <v narrator>on the artificial heart. <v John Bunker, M.D.>Want to get fixed-. <v Deborah Lubeck, Ph.D.>In those reports-. <v narrator>One of his colleagues is health economist Deborah Lubeck. <v narrator>She talks about that first artificial heart study in 1966. <v Deborah Lubeck, Ph.D.>These that report also assumed that the heart could be used by one <v Deborah Lubeck, Ph.D.>hundred thousand patients a year and that the cost would be about ten thousand <v Deborah Lubeck, Ph.D.>dollars per patient per year. Again, this is in 1966 dollars. <v Deborah Lubeck, Ph.D.>So those costs were very low in 1966 and are definitely extremely <v Deborah Lubeck, Ph.D.>low in in terms of the dollars today. <v Deborah Lubeck, Ph.D.>They also assume that the artificial heart implantation would not strain existing medical <v Deborah Lubeck, Ph.D.>resources or hospital resources at all. <v Deborah Lubeck, Ph.D.>And we found in 19-, 1980s that this isn't true, that many hospitals
<v Deborah Lubeck, Ph.D.>will not get involved in heart transplantation because it takes a large number <v Deborah Lubeck, Ph.D.>of surgeons and especially nurses and hospital assistants <v Deborah Lubeck, Ph.D.>and a great deal of post-operative recovery. <v Deborah Lubeck, Ph.D.>Time for a patient for one transplant that might be used by many other patients <v Deborah Lubeck, Ph.D.>who have other forms of heart surgery. <v narrator>In 1968, another review committee was formed to examine this objective heart <v narrator>replacement, including transplants and the artificial heart. <v narrator>Historian Barton Bernstein has studied the history of the artificial heart program. <v Barton Bernstein, Ph. D>By 68, 69 became clear that so far they had not found an acceptable <v Barton Bernstein, Ph. D>biomaterial which could interact safely with the blood. <v Barton Bernstein, Ph. D>They had not yet found an external and internal power source, <v Barton Bernstein, Ph. D>which would be reliable, compact, safe and cheap. <v Barton Bernstein, Ph. D>And furthermore, they had not yet learned how to simulate the autonomic nervous system. <v Barton Bernstein, Ph. D>That's the nervous system, which, among other things, regulates the heart in such a way
<v Barton Bernstein, Ph. D>that it gives us what we need to run or sit, climb stairs <v Barton Bernstein, Ph. D>or lie in bed. So basically what they're saying is there were fundamental scientific <v Barton Bernstein, Ph. D>problems which existed, had not been solved and were not imminently soluble. <v narrator>The first two studies had been done by technical specialists in 1973. <v narrator>A third group was formed to study the artificial heart. <v narrator>It was much different. <v Deborah Lubeck, Ph.D.>That group consisted of a priest ethicist, several economists, <v Deborah Lubeck, Ph.D.>several lawyers, as well as biomedical specialists. <v Deborah Lubeck, Ph.D.>And they were concerned with the technical problems of the artificial heart. <v Deborah Lubeck, Ph.D.>But they also raised questions about equitable distribution of the heart, the <v Deborah Lubeck, Ph.D.>protection of subjects of research involved in the artificial heart, <v Deborah Lubeck, Ph.D.>and address the issues of quality of life, the value of human life, <v Deborah Lubeck, Ph.D.>and whether an artificial heart might be the best way for an individual to to lead out <v Deborah Lubeck, Ph.D.>their lives. And these are issues that now are considered an essential
<v Deborah Lubeck, Ph.D.>part of a technology assessment that had not been considered in evaluations prior <v Deborah Lubeck, Ph.D.>to that time. <v Barton Bernstein, Ph. D>Generally, the enterprise of the quest for the artificial heart has assumed that if <v Barton Bernstein, Ph. D>and when they create a totally implantable artificial heart. <v Barton Bernstein, Ph. D>Everybody who receives it will live a long and comfortable life. <v Barton Bernstein, Ph. D>Now, that is a perfectly acceptable definition, is a peculiar notion <v Barton Bernstein, Ph. D>about reality. <v Barton Bernstein, Ph. D>There's nothing illogical about contending that everybody will live forever. <v Barton Bernstein, Ph. D>It just doesn't happen. Since people die in operations that are even minor. <v Barton Bernstein, Ph. D>Anesthesia is not always perfect and mistakes are made on the operating table <v Barton Bernstein, Ph. D>and devices, even in space shuttles, fail. <v Barton Bernstein, Ph. D>Why are some of the artificial heart would be the unique exception. <v Barton Bernstein, Ph. D>Only some combination of euphoria and unreality can propel <v Barton Bernstein, Ph. D>fuel and guide such peculiar kinds of technology assesments. <v narrator>The 1973 study, despite raising important questions for the first time,
<v narrator>continued to mandate the quest for the artificial heart. <v narrator>Another assessment in 1979 focused even more on matters of cost. <v narrator>If the technology works. <v narrator>Who will pay for it? Today, after four studies, this question still <v narrator>has not been answered for beneath it. <v narrator>There is a question we don't like to face. <v narrator>How much is human life worth? <v Richard Micherdzinski>I don't think you can equate that kind of thing with money. <v Richard Micherdzinski>Research, advancement of anything as <v Richard Micherdzinski>important as life itself or to the promotion of life or the development <v Richard Micherdzinski>of life. <v Richard Micherdzinski>I don't think you can do this with saying how much would it cost? <v Richard Micherdzinski>You know, because the mind, you know, it always goes back to the mind. <v Richard Micherdzinski>It's a very precious thing. Life is a very precious thing. <v Robert G. Mitchell>Money. The money will always be there. If it isn't funded by the government or the
<v Robert G. Mitchell>insurance companies, it'll come from someplace. It always has. <v Robert G. Mitchell>It always will. <v John Bunker, M.D.>Well, we are now at the point where we can do more in medicine <v John Bunker, M.D.>than we can pay for. At the moment. <v John Bunker, M.D.>Oh, we're approaching 10 percent of the GNP invested <v John Bunker, M.D.>in medicine and maybe society's willing to keep going. <v John Bunker, M.D.>But I don't think we can count on that in any event. <v John Bunker, M.D.>Society or its representatives in the Congress or somebody is going to have to decide <v John Bunker, M.D.>where it's got to stop and one of the things <v John Bunker, M.D.>which I would think was an appropriate question to ask the public is, <v John Bunker, M.D.>do you want this much money invested in an artificial heart? <v narrator>Despite concerns about cost. <v narrator>Development of the artificial heart continues here at Thoratec <v narrator>Laboratories in Emeryville, California. <v narrator>Scientists look forward to a less expensive artificial heart.
<v John H. Lawson, Ph. D>As for the cost of the artificial heart, it's it should be relatively inexpensive <v John H. Lawson, Ph. D>once it has been developed. <v John H. Lawson, Ph. D>If you compare it to other procedures that are done presently to take <v John H. Lawson, Ph. D>care of patients who have heart disease, one of the reasons we're working on artificial <v John H. Lawson, Ph. D>hearts is because when an- successful, artificial heart is developed. <v John H. Lawson, Ph. D>It can be manufactured. It can be stamped out unlike a heart transplant. <v narrator>At Temple University, Dr. Jacob Kolff has been developing surgical techniques <v narrator>for the implantation of the artificial heart. <v narrator>He questions the validity of any cost estimate. <v Jack Kolff, M.d>Unless you know exactly what the technology is able to do. <v Jack Kolff, M.d>And unless you can exactly determine the demand for that particular <v Jack Kolff, M.d>technology or the, or get a full understanding <v Jack Kolff, M.d>of all the applications of that particular technology. <v Jack Kolff, M.d>Its very difficult to assess where it's going
<v Jack Kolff, M.d>and the overall cost benefit effect that you might have. <v Jack Kolff, M.d>Now with the first application, but over the subsequent years. <v Jack Kolff, M.d>So if you ask economists, they'll come right back and ask, give us data. <v Jack Kolff, M.d>And so they come back to the scientist says, what's the data? <v Jack Kolff, M.d>And if we don't have the data like we don't have it for an artificial heart, <v Jack Kolff, M.d>they'd be very difficult to predict what it's going to cost, what its <v Jack Kolff, M.d>total effect is going to be. <v narrator>Nevertheless, for the people who are involved in technology assessment, the cost <v narrator>remains a major consideration. <v Deborah Lubeck, Ph.D.>If we look at only 32000 patients a year receiving the device at a very low cost, <v Deborah Lubeck, Ph.D.>we're talking about a program that would automatically run a billion dollars a year just <v Deborah Lubeck, Ph.D.>for the individual implantation itself. <v Deborah Lubeck, Ph.D.>Not counting continuing medical care. <v Deborah Lubeck, Ph.D.>But if we're talking about 60000 patients a year, we might run a program that <v Deborah Lubeck, Ph.D.>costs five billion dollars a year.
<v Deborah Lubeck, Ph.D.>Now, these are sums that are much larger than any other medical care program today. <v Deborah Lubeck, Ph.D.>That would be five times the cost of end stage renal disease program. <v Deborah Lubeck, Ph.D.>Five times the cost of coronary bypass surgery. <v Deborah Lubeck, Ph.D.>And then we need to be concerned with who will pay for artificial heart implantation <v Deborah Lubeck, Ph.D.>and continuing medical care, which might run several thousand dollars a year. <v Deborah Lubeck, Ph.D.>We experienced with the artificial kidney that when patients weren't able to pay. <v Deborah Lubeck, Ph.D.>We didn't want to deny them access to a device. <v Deborah Lubeck, Ph.D.>So the government agreed to cover the cost of the artificial kidney <v Deborah Lubeck, Ph.D.>through special amendments to the Social Security program. <v Deborah Lubeck, Ph.D.>If the government were to do that again today, that would be an enormous cost. <v Deborah Lubeck, Ph.D.>Each year, as we said, something from two to five billion dollars a year, that's <v Deborah Lubeck, Ph.D.>far dwarfs the sums that have been spent so far on research and development. <v Deborah Lubeck, Ph.D.>The same time, if we don't cover the procedure through government funding, <v Deborah Lubeck, Ph.D.>we might be denying the procedure to people who have supported <v Deborah Lubeck, Ph.D.>the research through their tax dollars.
<v Deborah Lubeck, Ph.D.>And we're going to be faced with an ethical dilemma about which approach we want to take. <v Daniel Callahan, Ph. D>We'll have to say we can't spend an infinite amount <v Daniel Callahan, Ph. D>of money on this this one disease. <v Daniel Callahan, Ph. D>Not only do we have other competing health needs, but of course we have competing social <v Daniel Callahan, Ph. D>needs as well. Education, transportation, national defense, the environment. <v Daniel Callahan, Ph. D>And I think the story in the future technologies is we'll probably <v Daniel Callahan, Ph. D>be in a position to say, yes, if we have more money, we could do more. <v Daniel Callahan, Ph. D>However, we can't spend all of our money here. <v Daniel Callahan, Ph. D>We have to find some way of rationing the resources we have. <v narrator>But even if society did decide that the cost of a technology such as the artificial <v narrator>heart would be too expensive. <v narrator>Could anyone really stop it? <v Barton Bernstein, Ph. D>The Congress had very little interest in the matter. <v Barton Bernstein, Ph. D>We're talking about a 10 million dollar a year project at a time when the NIH <v Barton Bernstein, Ph. D>budget was already well above a billion, when the national budget was running into
<v Barton Bernstein, Ph. D>the hundreds of billions. That's a case where the National Heart Institute and the <v Barton Bernstein, Ph. D>artificial heart program were generally the instigators, <v Barton Bernstein, Ph. D>conceivers, evaluators. <v Barton Bernstein, Ph. D>People who chose the contracts assessed fulfillment of contracts, in a sense, you can say <v Barton Bernstein, Ph. D>they had global responsibility designated by themselves, allowed by Congress, <v Barton Bernstein, Ph. D>promoted by the bureaucratic structure. <v Barton Bernstein, Ph. D>So they did everything. And therefore, they were assessing themselves. <v Barton Bernstein, Ph. D>Not surprisingly, they seldom assessed themselves critically and never harshly. <v Barton Bernstein, Ph. D>So it was a very easy matter as progress was less speedy than they had hoped. <v Barton Bernstein, Ph. D>Simply for them to readjust the schedule. <v Barton Bernstein, Ph. D>Many who deal with technology and this has been true in Western society <v Barton Bernstein, Ph. D>and reached a apex, I think in the 1950s and early 60s, <v Barton Bernstein, Ph. D>believe that most things that can be conceived can be done technologically. <v Barton Bernstein, Ph. D>It's only a matter of will, money, physical
<v Barton Bernstein, Ph. D>resources. And hence it, even when estimates prove wrong, <v Barton Bernstein, Ph. D>rather than not propelling reconsideration that propels instead <v Barton Bernstein, Ph. D>continued incentive. There's almost no events that can occur. <v Barton Bernstein, Ph. D>For most technologists, which will lead them to give up the quest. <v Barton Bernstein, Ph. D>So the quest for glory, the belief in the activity, <v Barton Bernstein, Ph. D>the fact that it's their vocation, their career and incomes depend <v Barton Bernstein, Ph. D>upon itm, all lead them comfortably in the same direction to continue. <v narrator>Considerations of cost lead to larger moral questions. <v narrator>For example, if artificial hearts are a scarce resource. <v narrator>How do we decide who gets one and who doesn't? <v Daniel Callahan, Ph. D>Let's say a scientist working in an artificial on bettering the artificial heart who <v Daniel Callahan, Ph. D>had no depends but representative a real national asset <v Daniel Callahan, Ph. D>and resource, well.
<v Daniel Callahan, Ph. D>At that point, I think anyone might find it very difficult to decide between that <v Daniel Callahan, Ph. D>person, say, and somebody who's lived a fairly poor lifestyle person, who <v Daniel Callahan, Ph. D>got the heart disease in the first place because he didn't take care of himself. <v Daniel Callahan, Ph. D>But who happens to have three or four children who are dependent on it, then I think you <v Daniel Callahan, Ph. D>could almost flip a coin. Morally speaking, because there there'd be no very clear, <v Daniel Callahan, Ph. D>rational way, I think, of coming to a perfect solution. <v Robert G. Mitchell>I don't believe you can differentiate between a doctor, a football player, <v Robert G. Mitchell>a locomotive engineer or anything else. If you are suffering, you're a human being. <v Robert G. Mitchell>And I believe it should go that way. <v Robert G. Mitchell>If you've got one or two or three months to live. <v Robert G. Mitchell>Give this person a heart. Give them a chance. <v Daniel Callahan, Ph. D>Perhaps the largest question is whether it's a good idea to do it at all. <v Daniel Callahan, Ph. D>What would the benefits be and what might some of the harms be? <v Daniel Callahan, Ph. D>Clearly, there are lots of people whose lives could be saved <v Daniel Callahan, Ph. D>for a time by an artificial heart, and their
<v Daniel Callahan, Ph. D>heart disease is one of the major killers in this country. <v Daniel Callahan, Ph. D>That that's clearly a benefit. <v Daniel Callahan, Ph. D>On the other hand, I suppose you might ask. <v Daniel Callahan, Ph. D>It may sound a little strange to do so, but, <v Daniel Callahan, Ph. D>you know, can we. How far can we go in trying to further <v Daniel Callahan, Ph. D>extend people's lifespan? <v Daniel Callahan, Ph. D>And that's, I think, a very hard question to answer. <v Daniel Callahan, Ph. D>Nobody wants to die. We'd all like to live longer. <v Daniel Callahan, Ph. D>On the other hand, of course, as our population lives longer and <v Daniel Callahan, Ph. D>longer we, we create a whole new set of social problems. <v narrator>Another important question involves allocation of resources. <v narrator>Why develop this particular technology rather than putting our money somewhere else? <v Barton Bernstein, Ph. D>There's at least some evidence that preventive medicine would have in the long run <v Barton Bernstein, Ph. D>advance the health and welfare more people and would be technologically <v Barton Bernstein, Ph. D>simpler and therefore some would contend, myself included, more appropriate. <v David J. Farrar, Ph. D.>Obviously, prevention is a very major area that would solve
<v David J. Farrar, Ph. D.>all of our problems. But even if we prevented disease tomorrow, <v David J. Farrar, Ph. D.>we have a number of generations that will be developing heart disease before <v David J. Farrar, Ph. D.>in the next 10, 20, 30 years. That would require some sort <v David J. Farrar, Ph. D.>of therapy in this area. <v Jack Kolff, M.d>There are a couple of factors that enter into it. <v Jack Kolff, M.d>One is, what is the probability that you will ever find <v Jack Kolff, M.d>a means by which to prevent the disease? <v Jack Kolff, M.d>If the probability is zero or one percent, then <v Jack Kolff, M.d>you can see that no matter how much money you put into it, it will never pay off. <v Jack Kolff, M.d>So then it becomes obvious that you are better off cost benefit speaking <v Jack Kolff, M.d>to cure the disease once it's developed. <v Jack Kolff, M.d>Or at least to ameliorate the effects of the disease once it's developed. <v narrator>Another question raised in assessments of the artificial heart concerns <v narrator>quality of life.
<v Barton Bernstein, Ph. D>What will it mean? To an individual to receive an artificial heart and suddenly to be <v Barton Bernstein, Ph. D>plucked from the number of death to be promised life. <v Barton Bernstein, Ph. D>Will artificial hearts last very long? <v Barton Bernstein, Ph. D>Will the suicide rate be higher? At present, we know that the suicide rate for people on <v Barton Bernstein, Ph. D>dialysis, kidney dialysis machines is somewhere between seven and eight times the normal <v Barton Bernstein, Ph. D>rate, holding everything else constant. <v Barton Bernstein, Ph. D>Will it happen for artificial heart recipients? <v Barton Bernstein, Ph. D>If so, what will it mean to them and to their families? <v Barton Bernstein, Ph. D>These are all the questions that warrant sustained analysis and <v Barton Bernstein, Ph. D>so far have received at best passing glances. <v interviewer>Just being short of breath meant much at the time. <v narrator>So far, only one man. <v narrator>Barney Clark, has had the experience of living with an artificial heart. <v interviewer>You remember what this whole thing might go. <v interviewer>Any words of advice for somebody who is going through this again? <v interviewer>If they were to come and sit and ask you what it was like, what would you tell him? <v Barney Clark>I'd tell him that it's worth it? It all turned out to either <v Barney Clark>die or to have it done.
<v interviewer>It's been hard for you, hasn't it, at times Barney? <v Barney Clark>Yes. It's been hard, but the heart <v Barney Clark>itself has pumped right along. <v Barney Clark>And I think it's doing well. <v Daniel Callahan, Ph. D>But clearly, most of the technologies, what they can often <v Daniel Callahan, Ph. D>do is they can extend our physical life, but they can't improve the conditions of our <v Daniel Callahan, Ph. D>life. They can't make us happy. <v Daniel Callahan, Ph. D>They only keep us alive. And what happens thereafter is quite a different <v Daniel Callahan, Ph. D>problem. <v narrator>One of the values of American society has been the technology, for its own sake <v narrator>is good, that it ought to be developed as a manifestation of the human possibility. <v narrator>But do we put too much emphasis on the quest and the achievement and too little <v narrator>on the effect of that achievement? <v narrator>It's important to note that the questions raised in assessing the artificial heart still <v narrator>have not been answered, nor have they slowed the development of the heart.
<v Daniel Callahan, Ph. D>We've we've become very hooked on technology in a basic way. <v Daniel Callahan, Ph. D>And of course, then you have to add onto that a kind of double <v Daniel Callahan, Ph. D>bind, namely that you create one technology to solve one problem, <v Daniel Callahan, Ph. D>and that then that technology creates a new problem. <v Daniel Callahan, Ph. D>Most obvious case, which are mainly one notices, is <v Daniel Callahan, Ph. D>we're, we're now seeing a very large and increasing population of <v Daniel Callahan, Ph. D>elderly in this country. That's good in one sense. <v Daniel Callahan, Ph. D>People are living longer. Meanwhile, however, we don't know how to deal with a <v Daniel Callahan, Ph. D>much larger, increasing number of the elderly. <v Daniel Callahan, Ph. D>Deal with them in any fashion now. <v Daniel Callahan, Ph. D>In that case, there don't seem to be any technological solutions that are <v Daniel Callahan, Ph. D>going to quickly come to the fore. <v Barton Bernstein, Ph. D>Historically, until the last ten or fifteen years, those who have questioned technology <v Barton Bernstein, Ph. D>have been seen as neanderthal. <v Barton Bernstein, Ph. D>As people who've been putting their head in the sand, resisting the waves of inevitable <v Barton Bernstein, Ph. D>and desirable progress, we've tended to forget historically and socially
<v Barton Bernstein, Ph. D>that much technology has injured as well was benefited. <v Barton Bernstein, Ph. D>I think in general we could say, looking at the process of industrialization. <v Barton Bernstein, Ph. D>The benefits have been greater than the injuries, but many were <v Barton Bernstein, Ph. D>injured more than they were benefited. <v Barton Bernstein, Ph. D>What's changing in the last 10 years is we fear that we're coming to the limits <v Barton Bernstein, Ph. D>of desirable technological solutions in many areas. <v Barton Bernstein, Ph. D>We're more aware of the costs, financial and social. <v Barton Bernstein, Ph. D>We're more shocked by costs, which earlier we did not recognize. <v Barton Bernstein, Ph. D>Love Canal poisons danger to the ecology, ruining the environment. <v Barton Bernstein, Ph. D>Injury to patients. All of these things were optimism, blocked us <v Barton Bernstein, Ph. D>from asking other questions and looking at pieces of evidence. <v Barton Bernstein, Ph. D>And sometimes the evidence was not all in. <v Barton Bernstein, Ph. D>All that has led to a process of reconsideration. <v Barton Bernstein, Ph. D>And I think the reconsideration is very healthy. <v Barton Bernstein, Ph. D>Doubts are very healthy, dialog is essential, and some of the
<v Barton Bernstein, Ph. D>projects being considered are undoubtedly dubious. <v narrator>The artificial heart, without question, is an impressive technological advance. <v narrator>But can we afford it? <v narrator>And by spending money to develop it, are we forgoing opportunities in other <v narrator>areas, opportunities that may, in the long run, help more people <v narrator>at a lower cost? <v narrator>These are the kinds of questions that need careful consideration in strenuous technology <v narrator>assessments. Once considered, they must be acted upon. <v narrator>The trouble is that assessing technology can be just as hard as developing it. <v Deborah Lubeck, Ph.D.>Technology assessment is a new methods that we're still exploring <v Deborah Lubeck, Ph.D.>in the best way to do it and to try and set up standards for a technology assessment. <v Deborah Lubeck, Ph.D.>We do know from past experience that a broad based group is really critical and <v Deborah Lubeck, Ph.D.>particularly a group that will look at the long term impacts and the indirect impacts of <v Deborah Lubeck, Ph.D.>a technology assessment.
<v Deborah Lubeck, Ph.D.>We also know that presenting the alternatives to a technology is a critical portion <v Deborah Lubeck, Ph.D.>of a technology assessment so that when we evaluate the artificial heart. <v Deborah Lubeck, Ph.D.>We also want to look at other alternatives to achieve increased <v Deborah Lubeck, Ph.D.>life expectancy for people who might have coronary heart disease, like heart disease <v Deborah Lubeck, Ph.D.>prevention programs. <v Deborah Lubeck, Ph.D.>We also need to gather more information about the best timing for technology <v Deborah Lubeck, Ph.D.>assessments. Worry one of stop a technology and its development and try <v Deborah Lubeck, Ph.D.>and evaluate its future impacts, its future cost, efficacy <v Deborah Lubeck, Ph.D.>and safety. And we also want to be concerned with the best way to diffuse <v Deborah Lubeck, Ph.D.>the results of technology assessments so that we can get it back to clinicians <v Deborah Lubeck, Ph.D.>operating in all areas of the countries and to the health care consumer so that they can <v Deborah Lubeck, Ph.D.>become better educated about the choices they make in their medical technology. <v Speaker>The National University Consortium has been funded in part by a grant from
<v Speaker>the Carnegie Corporation.
Time's Harvest: Exploring the Future
Technology's Heartbeat
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Maryland Center for Public Broadcasting
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The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia (Athens, Georgia)
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"'Technology's Heartbeat' is one of a series of films (Time's Harvest: Exploring the Future) produced as a part of a [future] studies course. This film is designed to explain the problems and issues involved in technology assessments, specifically the technology assessments done for the artificial heart. Its ultimate purpose it to make the student/viewer aware of the need for societal assessment and discussion of new technologies and their implications prior to the implementation of the technologies. "To accomplish this, the film explains the reasons for the development of the artificial heart, traces the history of various technology assessments done on the artificial heart and explains the still-to-be resolved issues surrounding this technology."--1983 Peabody Digest.
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Producing Organization: Maryland Center for Public Broadcasting
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The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia
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Chicago: “Time's Harvest: Exploring the Future; Technology's Heartbeat,” 1983-10-22, The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC, accessed June 9, 2023,
MLA: “Time's Harvest: Exploring the Future; Technology's Heartbeat.” 1983-10-22. The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Web. June 9, 2023. <>.
APA: Time's Harvest: Exploring the Future; Technology's Heartbeat. Boston, MA: The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Retrieved from