The “miracle” pig heart transplant plays with the expectations of desperate patients and makes clear how the system values certain lives over others.
that it was the “solemn obligation” of a hospital to provide care based entirely on medical need, not on his history. The irony—or rather, the noncompliance ethical dilemma—is that a patient’s past is never used as a reason for refusing treatment. Until it is. Bennett, by virtue of his noncompliance from years before, had already found himself on a hierarchy of care that had little to do with need, and everything to do with history.
For proof, we need look no further than medical history. When in 1968 Christiaan Barnard took the heart from a 24-year-old Black man named Clive Haupt and placed it in the chest cavity of Philip Blaiberg, a white dentist with chronic heart disease, he didn’t just inaugurate a new era of heart transplant—.
In the 50 years since the first successful human heart transplants, a great deal has changed technologically, but vulnerable people still bear more of the risk and reap fewer of the benefits. Bennett remains alive with his new heart, almost two weeks after surgery, but no one yet knows when he will be able to leave the hospital. Bennett may be moving scientific progress forward, but he does so for the benefit of patients who won’t have to take his risk.
Can we progress science without these ethical dilemmas? We can, but it would mean leaving the for-profit model of biomedicine behind. In all such cases, including the historical ones, supply and demand have meant that the best treatment options go to those who can afford them—those with the greatest financial means or personal connections. When scarcity comes, the false equivalence between money and value means the privileged get better care.
If medical research, particularly in the United States, can divorce itself from the capitalist myth of surplus, then there is hope for a future of truly accessible transplants. In that future, Bennett would be allowed on the human heart waiting list, rather than having to prove himself through experimental surgery. Perhaps he may still have opted to have the pig heart transplant, but it would have been a free and clear choice, not made because there were no other options.
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