Moral and Ethical Issues - Introduction to Biomedical Engineering - page 56

conventional therapeutic and nontherapeutic distinction just mentioned. Quoting the com-
mission, Alexander Capron in 1986 wrote the following:

refers to interventions that are designed solely to enhance the well-being of an indi-
vidual patient or client and that have a reasonable expectation of success. In the medical sphere, practices
usually involve diagnosis, preventive treatment, or therapy; in the social sphere, practices include govern-
mental programs such as transfer payments, education, and the like.
By contrast, the term

The term practice

designates an activity designed to test a hypothesis, to permit conclusions
to be drawn, and thereby to develop or contribute to generalizable knowledge (expressed, for example, in
theories, principles, or statements of relationships). In the polar cases, then, practice uses a proven technique
in an attempt to benefit one or more individuals, while research studies a technique in an attempt to increase
knowledge.

research

Although the practice/research dichotomy has the advantage of not implying that ther-
apeutic activities are the only clinical procedures intended to benefit patients, it is also
based on intent rather than outcome. Interventions are “practices” when they are proven
techniques intended to benefit the patient, while interventions aimed at increasing general-
izable knowledge constitute research. What about those interventions that do not fit into
either category?

CASE STUDY: THE ARTIFICIAL HEART
In the early 1980s, a screening committee had been set up to pick the first candidate for the
“Jarvik 7,” a new (at the time) artificial heart (Figure 2.3). It was decided that the first recipient
had to be someone so sick that death was imminent. It was thought unethical to pick someone
who might have another year to live when the artificial heart might well kill the patient
immediately.

FIGURE 2.3 The Jarvik-7 artificial heart, 1985. Courtesy of http://www.smithsonianlegacies.si.edu/objectdescription
.cfm?ID ¼ 172.