The year is 2025 and biomechanical organs have been perfected. All patients receive timely transplants thanks to the corporations that hold organ patents. But universal access comes with a cost. Transplant recipients that cannot keep up with payments fall victim to corporation employees who salvage the organs from their bodies. The process almost always results in death.
The plotline of Repo Men paints a bleak, albeit unrealistic, future of transplant medicine. Although the movie was a box office flop a couple years ago, it sensationalizes very real concerns about the direction of health policy as the technology of artificial organs advances.
Artificial organs were long considered merely “bridges to transplant” because of their temporary nature. Recently, the media has delved into successful anecdotes of people without pulses: those who have continuous-flow total artificial hearts that hum in lieu of the human heart that rhythmically thumps. For the past several years, bovine and human clinical trials have shown that patients can use fully artificial hearts for extended periods and even for a lifetime .
While many long-term alternatives to traditional transplant are still in development, the aim is to produce permanent replacement organs. Organ transplant policy currently already faces many issues, such as procurement, shortages, transplant tourism, and organ trafficking. In some ways, artificial organs will help alleviate some of these dilemmas. Nevertheless, the advent of widespread use of this new technology requires that health policy reform must begin to reflect the novel considerations of artificial organ transplant.
Repo Men’s dark, dramatic warning raises questions about future cost and access. Because artificial organs will likely have a higher up-front cost due to production, policy must address the role of relevant entities such as patients, taxpayers, medical technology corporations, and insurance companies in bearing the financial burden. In addition, revision of patient selection and management is necessary to incorporate this new option for permanent artificial transplants. Government regulation must consider how patents might affect the current structure of donor and recipient pools. Artificial organs offer increased supply, but current policy still has to update systems of equitable access and distribution.
Even if artificial organs are the future, traditional organ transplants will not soon become a thing of the past. Some might argue that demand from and use by the wealthy is necessary in order to endow the world with such new technologies. This logic advocates a trickle-down effect for access, with poorer populations benefitting through less competition for traditional organs. However, patient needs differ among individuals rather than socioeconomic status. An impoverished recipient who is a better candidate for an artificial organ must retain the right to receive one.
Moving forward, transplant policy must preemptively go through the process of reform to prevent this socioeconomic disparity. Policy regarding permanent artificial organs must expand upon the current aim of traditional transplant policy: universal and equitable access to health.
Baum, Dan. “No Pulse: How Doctors Reinvented The Human Heart.” Popular Science. 29 Feb. 2012. Web.