| Renal disease, which comprises a cluster of syndromes and less definable manifestations, has haunted mankind since the earliest of times. As such, it provides an especially rich focus for the study of medical intervention and the ideas that underpin and legitimize it. This dissertation examines a particular episode in the history of the artificial kidney, which was created first to palliate and then rescue the lives of patients stricken with an insidious form of kidney disease, uremia.; In particular, in a series of articles written in the mid-1940s by Swedish kidney researcher Nils Alwall, in which he describes the development of his own version of a mechanical kidney, he suggests ethical improprieties on the part of Willem Kolff, the medical investigator who is widely considered the "father" of the artificial kidney. Since Kolff and his associates became the targets of much more wide-spread criticism following the implantation of the Jarvik-7 artificial heart into Dr. Barney Clark in 1982 at University Hospital in Salt Lake City, Utah, the earlier criticism, cast within the framework of artificial kidney development, suggests important things about modern medical research, and artificial organ research in particular. These things concern the ways in which research is initiated, interpreted, and supported both inside and outside the formal medical community.; If this study turns on a particular problem (or conflict) that concerns medical ethics, it also uses this problem as a springboard for a broader discussion of not only the intellectual and social development of mechanical devices in medicine, but of the scientific as well as cultural "meaning" that has accrued from these artifacts. In particular, it emphasizes that even within the medical research community itself, the disease process known as "renal insufficiency" has defied the most carefully calculated and keenly elucidated attempts to capture its essence in terms that would remain stable over time and would remain useful in terms of investigation and treatment. Finally, it suggests that researchers' attempts to mimic the physiological functioning of the natural kidney with artificial devices were shaped not only by the limitations that formal science enacted upon them, but as importantly the social, economic, political, and (increasingly) ethical factors that imposed themselves from the culture at large. |
