Apart Together: Getting to the Heart of Biofixture Status

This project explores what it means to be a 'biofixture': a medical implant, transplant, or therapy that is morally analogous to a native body part. A motivating case is provided wherein a decision to deactivate a ventricular assist device (VAD) provokes discomfort in medical providers. Taking as a starting point a previous project where a similar case of provider discomfort around pacemaker deactivation led to the conclusion that pacemakers are biofixtures, an argument is made that VADs are likewise biofixtures, the deactivation of which would be more morally analogous to active euthanasia than to standard cases of withdrawal of life support. To this end, criteria for biofixture status are developed, motivated, and applied to VADs and other cardiopulmonary therapies. Clinical entailments of this account of biofixture status are considered and further avenues of research for better understanding the nature and moral import of biofixtures are proposed.