Biomedical Engineering Reference
In-Depth Information
which others become better or worse off. In other words, economists must choose whether they are
seeking maximum profitability or Pareto optimality as the measure of success in a given project.
In the consumer model, for example, the goal is to maximize the level of utility that a consumer
achieves, while subject to the constraints of the budget (essentially the total amount of money
available in a given project). This utility maximization is the endpoint. Some argue that utility
maximization is an ethical construct. This is a “greed is good” argument, since the overall benefit
of a large sector of society maximizing its own utility means overall growth. Certainly, there
is some truth in this. Capitalism does indeed provide many benefits. And, the failed models of
socialism are often due to the reduced incentives for individuals. In the producer model, firms
optimize by maximizing profits, given the limitations they face due to the wage rate (the price of
labor) and the rental rate (the price of capital).
None of these models in practice, however, produce the ideals in every situation. For example, if
something prized by society does not lend itself well to a monetary value, such as open space, health
care, or sensitive environmental habitats, the consumer and producer models begin to collapse. Gar-
rett Hardin's “Tragedy of the Commons” addresses this deficiency (see discussion in Chapter 9).
Essentially, then, engineers must be creative and intuitive in modeling success. The bioengi-
neering aspects of this blend are well articulated by James B. Bassingthwaighte, Professor of
Bioengineering, Biomathematics, and Radiology at the University of Washington:
Current risk/benefit analyses of potential new drug therapies are not sufficient to the task. In general,
current analyses are based on the inference that a drug acts on a single protein, usually an enzyme or a
transporter; efficacy and side effects are determined later by observation. We need a great leap forward
that will enable us to make “knowledgeable” calculations of risks and benefits. We need information
on which decisions can be based. In the United States, new technologies, such as gene-insertion,
stem-cell infusion, and new pharmaceuticals are within the purview of regulatory agencies, such as
the Food and Drug Administration, rather than scientific funding agencies. The mission of regulatory
agencies is to protect us against speculative or risky advances. These agencies depend heavily on large,
expensive clinical trials in which some human subjects are put at risk in the interest of protecting
others. For novel interventions, which offer great possibilities but little evidence for predicting success
and a high risk of failure, harm, or damage, we must find another way to move ahead, but with
minimal risk. In other words, we must find ways that enable us to follow our intuition and insight by
maximizing our ability to predict risks and benefits.
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Thus, human enhancement is an optimization between risk and opportunity.
Intuiting
Value
The foregoing discussion provides some important guidelines for human enhancement.
Optimization for engineers involves creativity and intuition. Essentially, engineering involves
design under constraint.
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Engineers strive to optimize the level of elegance of a given structure
while subject to the constraints of fixed physical and mental resources, as well as the demands
of the marketplace. At the same time, engineers additionally face the greatest constraint of all:
safety. This constraint becomes more important than the aesthetic and economic aspects because,
as articulated by Henry Petroski:
