Heart: A History

by Sandeep Jauhar

Today, patient autonomy and shared decision making are mantras in the hospital, ethical imperatives that supersede all others, including beneficence. But the situation was very different in the 1950s, when doctors were more apt to act without what we would consider informed consent. Medical paternalism was rampant, but it would be a mistake to think of Lillehei as authoritarian. By all accounts, he was an unusually compassionate physician, having been a patient himself. As a patient, he knew the vulnerability that comes with illness. He knew on a visceral level how patients look to their doctors for guidance and protection. But as a surgeon, he also understood that his young patients had no chance for a normal life and that there were no other procedures available to help them. Desperate parents did not want to hear that there were no options. They wanted a doctor to do—try—something.