Vanderbilt Law Review

First Page



On December 3, 1967, the first human heart transplant was performed by Dr. Christian Barnard in Capetown, South Africa.' Although the achievement received a great deal of attention, it is clear that its principal import is in the perfection of new surgical techniques, rather than in conceptual innovation. Organ transplants have been performed for many years, from the simplest, a blood transfusion,to more complex and hazardous therapeutics, such as skin grafts and kidney transplants. Anatomically, the heart is no more important or necessary an organ than the kidney or the liver, but common subjective notions of the heart's central function have led to greater fanfare over the recent spate of heart transplants following Dr. Barnard's feat than has met earlier surgical firsts. Underlining the legal and ethical problems in any transplant situation, however, is the fact that the heart, to a greater degree than any other organ so far transplanted, must be removed from the donor within a few minutes after death; and unlike the effect upon the recipient of a blood transfusion, removal of the transplant recipient's damaged heart ensures his death if the operation is unsuccessful. The legal and ethical problems are evident. Given the fame which follows this untried form of therapy, a doctor may be accused of" experimenting" on a patient. Further, since the donated heart must be "alive" at the time of the transplant, the question may arise as to when the donor is sufficiently "dead" to allow removal of the organ. Finally, given the disparity between supply and demand, when a heart does become available, the question arises as to which of the demanding patients is to receive it.