Quality vs. Quantity of Life

Reading the article The Artificial Heart: Not Just a Pump in Scientific American raised the issue of quality of life vs. quantity of life.

I knew that in the early 1980s an artificial heart, the Jarvik-7, had been successfully implanted into a man who would have died without the device beause of his own failing heart. What I hadn't realized before reading this article was what kind of quality of life Mr. Clark (the patient) had after receiving the artificial heart.

We all have this image in a heads, probably most from television shows, of a patients who undergoes a heart transplant and receives a donor heart, which gives him or her a second chance. The leave the hospital looking healthy and happy and go onto to live for 5, 10, 15 years, or more.

Unfortunately, this wasn't the case for Mr. Clark. He was never able to leave the hospital after the artifical heart was implanted. In fact, the compressor that powered the artificial heart was the size of a refrigerator and Mr. Clark was tethered to this compressor the entire time. During the 112 days that he survived after the surgery, he suffered convulsions, cognitive problems, kidney failure, and then died of massive organ failure. Because of the scientific and medical implications of this procedure, the press followed the story closely. The public watched Mr. Clark's progress and then his decline. His quality of life during this time was so poor that many Americans were turned against the idea of artificial hearts for the next decade.

While researchers would probably argue that every patient who undergoes a procedure such as this one furthers scientific and medical progress, what does it do for the patient himself? In the end, was it worth it to Mr. Clark? Would his quality of life at the end been better if he'd spent his final days with his family, rather than undergoing surgery and hooked up to so much medical equipment? Should researchers wait longer before performing such procedures on humans? At what point is the quantify of life worth the quality? Should a patient with terminal cancer be encouraged to try yet one more treatment, even if the chances of it improving their outcome are minimal, or should they go home and spend their final moments with their loved ones? These are sensitive issues and often best decided by the patients and families themselves.