A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program - and in particular, the National Institutes of Health’s major investment - raising important questions. The volume includes: consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments; a look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions; examination of how this technology’s use can be targeted most appropriately; and attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds.