Baby Fae's death after her baboon animal heart transplant: a tragic 1984 cross species surgery
Baby Fae should not have been given the heart of a baboon. Lucy Shelton of People for the Ethical Treatment of Animals accused doctors who transplanted the heart of a primate into the dying newborn of “medical sensationalism at the expense of Baby Fae, her family and the baboon” (1). A Minnesota surgeon John Najarian explained that “there has never been a successful cross-species transplant” and therefore “to try it now is merely to prolong the dying process” (1).
However, some people were in favor of the procedure. Dr. John Collins was one of them. He countered dissent with the following opinion: “If we all were afraid to attempt the untried, we would have no new treatments” (1). Unfortunately, his argument ignores the fact that this experiment constituted medical malpractice for several reasons: the surgeon was unqualified for the operation, other options were not properly investigated, Fae's parents may not have been correctly informed, and there was absolutely no reason to believe it would succeed and every reason to believe it would prove fatal. Therefore there are many more reasons beyond simply being “afraid to attempt the untried” why the surgery should never have taken place.
Dr. Leonard Bailey was the cardiac surgeon responsible for the 1984 Loma Linda Hospital based transplant of a baboon heart into Fae, a human newborn. While he had previously treated infants with hypoplastic left-heart syndrome, a fatal condition that Baby Fae was born with, he had limited experience with human heart transplants (2). In fact, Loma Linda did not even have a human-heart-transplant program (1).
Dr. Bailey had performed over 150 transplants in sheep, goats, and baboons, some of which were interspecies surgeries, but any successes in that area should not be seen as applicable to transplants in humans, another species entirely. Because Dr. Bailey had minimal expertise in human heart transplantation in general, and had never attempted the even more complicated transplantation of placing an animal heart into a human, he was not the ideal candidate to complete Fae’s surgery.
Furthermore, to add to the odds of success, baboons were known not to be ideal donors for humans. Dr. Bailey himself found evidence that chimpanzee, orangutan or gorilla organs would likely give better results, but did not use them. He explained that each was “either an endangered species or [didn’t] procreate well in captivity” (1). Therefore Dr. Bailey went into surgery without appropriate transplanting experience and also with the knowledge that the heart he was transplanting was an inferior type. Although he gave reasons why other animals organs could not be used, he did not convincingly explain why other medical procedures were not pursued, especially when the odds were so highly stacked against his success.
For example, Dr. William Norwood, a chief of cardiac surgery in Philadelphia, had developed a procedure in which babies with heart defects like Fae’s could be treated without requiring an additional organ (1). The Norwood method surgically rerouted blood into the functional half of the heart instead of the underdeveloped half. 40 out of 100 patients had survived the treatment by the time of Fae’s surgery. While these are not fantastic odds, any cardiac surgeon would know that they were still much better than those of using a baboon heart. However, Dr. Bailey was not the only one to have ignored viable alternatives. The Loma Linda hospital as a whole was guilty of severe negligence in this regard.
This is because, in addition to the option of surgically rerouting the blood in Fae’s heart, a two-month-old infant’s heart was actually available on the day of Fae’s surgery. However, the hospital made no request for it. Hospital officials later gave several reasons why this took place.
First, they said that the call came after the baboon heart procedure was complete. However, if they had not approved the highly experimental procedure to begin with, against all odds of success and in spite of better alternatives, this would not have been a problem. Second, they claimed that the heart of a two-month-old “might have been too big for Fae” (1), although by their choice of the word “might” it is obvious that they were not certain of this fact. At the time of the surgery, the chances of surviving when given a baboon heart were proven nonexistent. Therefore the chances of surviving after receiving a slightly over large heart were by default superior.
Lastly, the hospital claimed that it would have taken too much time to carry out necessary testing to ensure the human heart was compatible. This may actually have been true, but given the weakness of their other arguments and their failure to even attempt the process, they deserve skepticism. Further, hospital officials admitted later that “they simply had not considered the possibility of a human donor” (1), which is outright ridiculous. When human donors are the only donors used in virtually every live heart transplant operation, how could their use not even have occurred to the officials of an until-then reputable hospital?
Michael Gianneli, a Fund for Animals science advisor, was completely justified when he asked the following question: “If they didn’t even look for potential life-saving alternatives, what does this mean in terms of the ’informed consent’ of the parents?” (1). The hospital claimed to have informed them properly, but they also admitted to having neglected to consider the most obvious and potentially successful option available to them by using a human organ.
If Fae's parents had been told that Dr. Bailey was not a well-practiced heart surgeon, that every previous cross-species transplant attempted had failed, and that the baboon heart was not considered the best animal organ available, it is hard to believe they would have signed on the dotted line. If they were also told about Dr. Norwood’s surgical procedure and the fact that their signatures would mean no other far superior options, such as a human infant’s heart, would then be considered, it is almost guaranteed they would not have consented.
The only reason why parents would pursue such a route would be sheer desperation or for the publicity such an operation would excite. There was no reason for Fae’s parents to feel so desperate as to attempt an almost proven fatal type of operation when there was also one available with a forty percent survival rate. There was no reason why they would have wanted to use a baboon heart instead of a human one, if the option had been pursued by officals and made available to them. And their true identities and that of their child were concealed from the public for the sake of anonymity, proving they had no desire to sacrifice the well-being of their child on a sensational experiment and a chance in the spotlight.
What happened to Baby Fae is simply a tragedy. Antivivisectionists at the time called the procedure “ghoulish tinkering with human and animal life” and they were correct (1). There is no guarantee that Baby Fae would have lived even if she had not received the baboon heart and had undergone a different procedure instead. But her death was almost guaranteed with the use of the animal organ. The doctors and the hospital involved brought about Fae’s death through negligence and a likely misrepresentation of facts to her parents. Therefore it should not even be considered a failed experiment but instead as an example of unethical and immoral medical malpractice, the cost of which was paid with Baby Fae's life.
(1) TIME in partnership with CNN. Baby Fae Stuns the World. Wallis, Claudia. Nov 12 1884. Accessed at http://www.time.com/time/printout/0,8816,926947,00.html
(2) The Rights of Animals. Roleff, T., Hurley J. 1999 Greenhaven Press, San Diego, CA. Page used: 82