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Monetary Costs, Profit, and the Quality of Life
Margot L. Harris 001242-0103
IB Approaches to Learning SL
17 December 2015
Word count: 1458

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Biomedical Engineering can take on many forms, including but not limited to: surgical
machinery, prosthetics, testing methods, and even drug administration. (Examples and
Explanations of BME). Biomedical Engineers have to consider a wide array of contexts when
designing their products so that the creation can work to its intended use. Designing mechanical
heart valve prosthetics currently affects the ethics of the biomedical field through the ethical
dilemma of the amount of profit made along with people’s quality of life. Given that context,
designers consider decisions within the same engineering paradigm of monetary costs versus the
value of people’s quality of life. Pursuing this further, designers have produced multiple classes
of designs including but not limited to: St. Jude’s Bileaflet, Starr-Edward’s ball and cage, and
Bjork-Shiley tilting disc. (Bloomfield, Peter). Each proposal within a range of specifications,
weight and other variables. In that respect, is it ethical to sacrifice a patient’s financial stability
to lengthen their life? In broader terms, is it ethical to make an excessive profit for research
incentive or could it be considered greed? In addition, is it ethical to give a patient anxiety
concerning the procedure for any length of time?
Internationally twelve million people suffer from rheumatic heart disease, one in every
four of them have extreme cases of congestive heart failure that requires cardiac valve
replacements (International Cardiovascular Disease Statistics). These high statistics should show
biomedical engineers the necessity for quick and ethical solutions for patients worldwide. With
multiple perspectives considered through the international market of patients, professionals must
remain confident and open-minded. A person requiring a valve replacement in America might
have different concerns than someone in African regions; concerns might include sterilization of
the surrounding environment, cost, and recovery time. (Heart Disease Statistics).

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Five percent of the global population above the age of 65 risks developing heart disease,
within that specification most patients support minimally invasive procedures. Being explicit,
most patients desire minimally invasive procedures with quick recovery times and economically
minded costs. (TAVI market). Yet, when the disease shifts severely, the necessity for surgery
becomes immediate.
The first ethical dilemma outlines the significance of extending someone’s life for a
monetary value and the repercussions of their stress, described by Rushmore Kidder as a long-
term versus short-term paradigm. A short-term view focuses on the comfort of the patient and
their degree of suffering rather than the long-term perspective of a longer duration of health. In
comprehensive terms, can professionals weigh the worth of excessive recovery time, possible
complications, and stress on the patient?
In terms of the short-term view, many medical care facilities strive toward the goal of
having a strong consideration for the quality of life, yet biomedical engineering has different
focuses than pure patient care. Within this archetype, certain things have the need for a semantic
definition: what defines a “good” quality of life, who gets to define that, and the different
resources allocated for those in need. (QUALITY OF LIFE, HEALTH AND HAPPINESS).
Taking a professional stance on a life equates to an ethical dilemma itself, people have more than
monetary value, and taking an objective stance can seem disrespectful depending on the
circumstances. Multiple societies have considered this dilemma; many still believe that a
person’s life cannot reduce to a political and social portrait. In-order to take a true gauge of
someone’s life, it needs to be multidimensional and their direct perspective needs to be taken into
consideration. This multidimensional approach should see social, risk, health, and living
conditions; each can play a role in happiness, but we cannot assume that happiness equates to a

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“good” quality of life. (Measuring Quality of Life). To finalize the point, a panel of medical
professionals should decide a patient’s quality of life. Once the quality of life of the patient has
been classified as “good” or “bad”, the respectable medical professional takes the necessary
steps, depending on the patient’s circumstance, to present the next viable option to the family. If
the panel defines the patient’s quality of life badly, a vast range of options present themselves to
the patient, some include euthanasia and extended life support.
Multiple variables need investigation for a long-term view. Science has not progressed to
the point where immortality is an option, so medical professionals assisting the patient would
need to decide the correct time extension and its feasibility for the patient. The definition of
health has many facets. The basis of an individual’s health builds off five factors: the
environment, the awareness of individuals and communities about health, personal hygiene,
health care, and disease. (Achieving Good Health).
Although defined as a purely medical ethical dilemma, biomedical engineers need to
take those perspectives along with their own regards. To narrow the ethical dilemma, each side
of the paradigm shows a range of possibilities for mechanical heart valves. To ensure the
demonstration of each side of the paradigm, manufacturing firms have stages of quality control
to ensure safe mechanical heart valves. The manipulation of different variables within quality
control can serve the patient best; they include materials, sterilization, the disposure of waste,
and assembly methods (Artificial Heart Valve). However, what gives engineers the incentive to
produce the product, and when does that profit become excessive?
On average, heart-valve replacement patients pay 80,000-200,000 dollars and beyond for
surgery, 50-350 dollars for post-operation physical therapy, and 15-25 dollars per month for
blood thinning medication (How Much Does Heart Valve Replacement Cost?). With a rough

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calculation of the lowest amount possible to pay, a client can be responsible for 10,454.60-
28,686.76 dollars annually for ten years (Weekly Payment Loan Calculator). In favor of patients
in need, the Centers for Medicare and Medicaid Services arranged to pay the same rate for those
patients who could not afford treatment. The medical community composed of surgeons, nurses,
and any healthcare providers remain experienced with patient care and the inability to remain
financially stable through the process of surgery frequents their offices regularly. Although the
yearly expenses for patients creates a heavy impact, the price for invasive prosthetics tends to be
seemingly less than perceived. The average heart valve prosthetic typically costs 4,000-7,000
dollars and the Centers for Medicare and Medicaid Services payment does not cover both the
device and procedure. Regardless of the fiscally friendly device’s expense, this client still has to
undergo an invasive surgical procedure.
Although these devices are mainstream, innovations are making their way through the
market place. Most recently, trans-catheter aortic valve replacement, or TAVR, has introduced
itself onto the medical forum. This new minimally invasive method provides treatment for high-
risk patients who cannot receive typical aortic valve replacement ("What Is TAVR?"). This
option shows some risk, patients with TAVR’s have a doubled rate for risk of stroke. TAVR,
approved for patients with Medicare or Medicaid, cannot be covered due to the high price for the
device and procedure. The device costs up to eight times as much as a typical aortic valve
replacement. This extreme cost of 30,000-74,000 dollars keeps the beneficial product unavailable
to most of its target audience (UPDATE). Who benefits from the excessive profit?
Typically, these biomedical engineering companies can have net sales reaching 615
million dollars on single projects, but considering the high gains, they filter a considerable
amount of 88 million dollars on quarterly R&D expenses. These quarterly expenses can add up

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quickly to 264 million dollars, taking a chunk out of their 615 million dollar net sale, decreasing
profit to 315 million dollars (Edwards profit). Upon delving deeper into the presented issue,
programs have explored lowering the cost for affected patients. Although the issue, abundantly
known amongst corporations, whom profit from the overcharge, continually upscale the cost
instead of deflating the price and solving the issue. The assumed solution of lowering the cost
has overlooked issues, such as discouragement amongst the innovators behind the
groundbreaking medical technology. The community needs to understand the multiple outlooks
of the same issue, including those affected, and work together to fulfill the demands of patients
and corporations equally.
In the beginning of my research, I thought that there would be an easily seen
dilemma and solution, but as my research progressed, I realized that was not the case. Toward
my conclusion, I collected two ethical dilemmas with possible practical solutions, and supporting
data. Research and its coordinating data can tell a quantitative story along with a qualitative story
about different types of disorders, solutions, sketches, and much more. I believe that each aspect
of each ethical dilemma can be supported with the right amount of planning and coordination
based on the patient range that a designer would receive. The range of global perspectives,
community guidelines and opinions, and ethical standpoints have given me the tools necessary to
see my career pathway’s role in a larger public district.

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Bibliography
Achieving Good Health. (n.d.). Retrieved October 27, 2015.
Artificial Heart Valve. (n.d.). Retrieved October 27, 2015.
Bloomfield, Peter. "Choice of Heart Valve Prosthesis." Heart. Copyright 2002 by Heart. Web. 22
Oct. 2015.
"Edwards Profit up 23%, but Increased TAVR Competition Looming." FierceMedicalDevices.
Fierce Market, 24 Oct. 2014. Web. 17 Dec. 2015.
Examples and Explanations of BME. (n.d.). Retrieved October 27, 2015.
Heart Disease Statistics. (2014, February 28). Retrieved October 27, 2015.
"How Much Does Heart Valve Replacement Cost? - CostHelper.com." CostHelper. CostHelper
Inc. Web. 10 Dec. 2015.
International Cardiovascular Disease Statistics. (n.d.). Retrieved October 27, 2015.
Measuring Quality of Life. (n.d.). Retrieved October 27, 2015.
QUALITY OF LIFE, HEALTH AND HAPPINESS. (1996). Retrieved October 27, 2015.
Transcatheter Heart Valve Replacement (TAVI) Market: Global Industry Analysis and
Opportunity Assessment 2015-2025. (n.d.). Retrieved October 27, 2015.
"UPDATE: Recent CMS Reimbursement Coverage Calls Attention to TAVR Financial Picture."
The Advisory Board Company -. American Health Line, 9 July 2012. Web. 17 Dec.
2015.
"Weekly Payment Loan Calculator |- MyCalculators.com." Weekly Payment Loan Calculator |-
MyCalculators.com. Mycalculator.com. Web. 10 Dec. 2015.

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"What Is TAVR?" What Is TAVR? American Heart Association, 26 Aug. 2015. Web. 17 Dec.
2015.