Mickey Eisenberg sounds a new controversial suggestion in an editorial in today's issue of the Journal of the American Medical Association: Make automatic external defibrillators (AEDs) available for purchase over-the-counter so that people might have them at home. There are now many plans to get these devices out of the ER and into public spaces like gyms, planes, sports arenas and government office buidlings. But AEDs in public spaces, Eisenberg argues, would help only about 16 percent of the annual cardiac arrest cases in the U.S.

In contrast, as many as 75 percent of people who die suddenly of heart disease--the leading cause of death among U.S. adults--do so at home. Were defibrillators and trained family members at hand, the editorial suggests, many might be saved. "CPR has become a lay procedure--anybody can learn it, and it is assumed that bystanders will use it in emergency situations," says Eisenberg, who created a site for teaching CPR (right). "Similarly, there is growing awareness that defibrillation is moving into the community."

Current obstacles to Eisenberg's dream of home defibrillation are not insignificant. For one thing, the devices are expensive, starting at about $3,000. Also, the Food and Drug Administration must first be convinced that--with sufficient labeling and instruction--the devices are safe and efficient. But for Eisenberg, who has received funding from defibrillator manufacturers, the campaign is not new. See his article in the June 1998 issue of Scientific American.