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Week of 26 March 2004 · Vol. VII, No. 25

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NPR's Talk of the Nation: Artificial heart may be used as pretransplant lifesaver

On March 17, a federal advisory panel recommended that the Food and Drug Administration allow the nation's transplant centers to use an artificial heart to try to keep dying patients alive long enough to receive a new heart. The history of the artificial heart and whether the high costs and risks associated with the device outweigh the benefits were discussed by George Annas, BU's Edward R. Utley Professor of Health Law, Bioethics, and Human Rights, on National Public Radio's Talk of the Nation on March 18. “It's the same basic heart, a little bit modified, that was used . . . back in 1982,” he said, referring to the first artificial heart transplant. “It's a fully implantable device that takes the place of your heart — your heart actually has to be removed — and it is connected to a large console which is used to pump air in and out of the heart to actually move the heart valves.” According to Annas, even though there have been plans for 20 years to make a backpack-type battery pack, allowing patients to be ambulatory, the console “means the patient has to stay in the hospital, hooked up to this, essentially for the rest of his life.” Annas said that the original intention for artificial heart transplants was to give patients a permanent heart, until the first five patients died from strokes and clots. “So it was then proposed to use it as a so-called bridge to transplants,” he said. “People who would be eligible for it were people who were eligible for a heart transplant, but who hadn't received one because a heart hadn't become available.” The only people who can benefit from receiving an artificial heart, he said, are those who actually do get a human heart, and “the total number of human heart transplants we can do in the United States is limited by the available hearts out there. And the fact is that a temporary artificial heart can't change that number, so it can't actually save any net lives of U.S. citizens for heart transplants.” The cost, he added, includes one of the most expensive procedures in medicine — heart transplantation — as well as the actual device, which is close to $100,000, and the in-hospital stay of “multiple thousands of dollars a day as long as it takes,” which could “double and probably triple the cost of the individual's heart transplant.” Annas feels that it's questionable whether insurance will pay for the procedure: “Some will and some won't.” He added that “you have to ask first, will Medicare pay for it, then will health maintenance organizations and health plans pay for it . . . the more important question is whether heart transplant surgeons around the country will think this is a good idea and whether they will want to use this device.”

Los Angeles Times: Cottle, like, states his views on the generation gap

In a commentary in the March 22 Los Angeles Times entitled “Norah Jones? Like, Just Where Did Tom Jones Go?” Thomas Cottle, an SED professor of education and special education, offers his views on the different stages of human development, based on pop culture and trends in American society. “I'm in what is best described as Stage Nine — the ‘this time life really has passed me by' stage, to be followed by the final stage — ‘the world has passed me by but I don't care,' ” he writes.

“Evidence for having entered Stage Nine, what a contemporary's young son calls ‘early old,' is everywhere. Watch the Grammys and find yourself equally unacquainted with the old stars, the new stars, the old songs, the new songs, and every product advertised. . . . Equally significant is the Stage Niners' need for politeness and good grammar. We get weak in the knees when we realize that no one has said, ‘have a nice day,' much less ‘thank you' in a store, gas station, or bank in the last month. We're appalled that the elements of grammar now are ‘y'know,' ‘like,' and ‘and stuff.' Through years of training, Stage Niners have come to believe that the word ‘like' portends the arrival of a simile. . . . With one sweeping look back at history, Stage Niners know full well that ‘early old' is an oxymoron. If I can neither prevent the VCR clock from blinking nor find my way onto the Web, and medical science no longer makes parts for my particular anatomical model, I need no longer fear death. Moreover, given that the farthest I can travel on the information highway is the breakdown lane, a wondrous irony may await me. Amid all the technological changes, Father Time may be so frustrated with my out-of-date browser he may not even find me. Stage Nine is not the end of life. The time to worry is when a disembodied voice says, ‘Like, you've got mail, and stuff.'”

Channel NewsAsia: Taiwan president's possible push for island's independence could lead to war

Chen Shui-bian, who recently won reelection as president of Taiwan by receiving 50.1 percent of the vote, may seek a referendum in two years on a new constitution for the island that would formalize its half-century of informal independence from mainland China, reports Channel NewsAsia on March 22. Chen Shui-bian is known to desire independence for Taiwan, and the fact that he received a majority of votes this year compared with the 39.3 percent he received four years ago may buoy his confidence to pursue this path, which could draw strong reaction from China. “Is there a chance of military confrontation in the next four years? Certainly,” says Joseph Fewsmith, a CAS professor of international relations and a China scholar. “We need to have cautious and sober minds on all sides.” He adds that while a full-scale invasion of Taiwan proper is unlikely, possible Chinese military options range from missile tests to blockades or an assault on small Taiwan-controlled islands near the Chinese mainland.


26 March 2004
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