The artificial heart as a bridge to transplant: ethical and legal issues at the bedside

The healthy survival of two thirds of patients who receive the total artificial heart as a bridge to transplant is argument for continued use of this technology. Patient selection, informed consent, and treatment termination are the ethical and legal issues that are important at the bedside. Optimum patient selection requires clinical judgment, appropriate institutional review, and the elimination of socioeconomic barriers to transplant. Informed consent enables the patient to participate in the decision and to consider the question of treatment termination in a personalized fashion. Favorable public perception and successful implementation of this bridge to transplant are linked to the quality of this physician-patient communication.