The recent coverage of ECMO by the Wall Street Journal has shone a spotlight on a therapy that, despite its decades-long existence, remains relatively obscure and underutilized. While the article thoughtfully delved into the ethical considerations surrounding the extended use of this life-saving therapy, it’s important to recognize that many hospitals have yet to offer ECMO as an available treatment option. The priority focus should be on expanding access to this critical therapy, affording patients and their families the opportunity for life, not just contemplating the long-term ethical considerations that may or may not arise.
When introducing any new therapeutic approach, it takes time for research and clinical knowledge to accumulate in order to optimize its application. ECMO was no exception to this rule. But, as highlighted in The Wall Street Journal article, this continued commitment has yielded positive results, with survival rates reaching as high as 70 percent in recent years. This improvement has granted a renewed lease on life to patients who, in the absence of ECMO, may have otherwise died.
The increasing awareness of ECMO, combined with the rising survival rates, is a testament to the collective efforts of the medical community, as well as advancements in technology and patient care. Several factors have contributed to these improved outcomes. Firstly, with the prolonged use of ECMO machines, a rethinking of patient care has occurred, and early mobility and rehabilitation have become crucial. The benefits of these initiatives are profound, enabling patients to regain strength and functional independence. In many cases, they become active participants in their recovery journey.
Another driving force behind these improved outcomes is the continuous expansion of our knowledge about ECMO. In the 50 years since ECMO was first introduced, the field has seen thousands of hours dedicated to research and clinical trials, substantially broadening our understanding of this therapy and its clinical applications. This has helped to expand and improve the educational resources available for health care professionals, better identify the patients most likely to benefit from ECMO, and develop robust policies and protocols.
Innovative research and development initiatives have also spurred the continuous improvement of ECMO technology. One of the best and most recent examples enables patients to venture beyond the confines of the ICU while still benefiting from essential ECMO support. An ECMO machine that supports mobility and independence is paramount to successful outcomes and will help further the integration of this life-saving therapy into mainstream medical practice.
With continuing news coverage and growing awareness of ECMO, hospitals have a responsibility more than ever to offer access to this therapy. While ethics undoubtedly guide our decisions, our primary aim remains to provide hope, healing, and a chance at a brighter tomorrow. As with any ethical dilemmas that arise from advancements in medical technology, these decisions should be handled thoughtfully and compassionately, hand-in-hand with the people whose lives are affected.
John R. Mehall is a cardiothoracic surgeon and physician executive.
