Biomedical Engineering Reference
In-Depth Information
Impact. How much difference will the technology
make in improving health?
Appropriateness. Will it be affordable, robust, and
adjustable to health care settings in developing
countries, and will it be socially, culturally, and
politically acceptable?
Burden. Will it address the most pressing health needs?
Feasibility. Can it realistically be developed and
deployed in a time frame of 5-10 years?
Knowledge gap. Does the technology advance health
by creating new knowledge?
Indirect benefits. Does it address issues such as
environmental improvement and income generation
that have indirect, positive effects on health?
The top three areas require major advances in biomedical
engineering ( Table 8.2-1 ). The fourth area is within the
domain of environmental and civil engineering. The fifth
area is a challenge for genetic and tissue engineers. The
sixth area falls within biomedical engineering research
and clinical engineering. The seventh area combines the
work of computer engineers and biomedical engineers,
while the eighth area is a blend of agricultural and bio-
medical engineering with food sciences. The ninth area
will require advances in biomedical, clinical, and tissue
engineering, and the tenth area will call on computational
pharmacological modeling (e.g., compartmental models),
material sciences, biomedical engineering, and chemical
engineering. This is evidence that bioethics is a growing
concern for all engineering disciplines. Notably, each of
these technological areas is associated with bioethical
issues, but in very unique ways.
Regarding biomedical engineering, both parts of the
term ''biomedical'' are important. Again, ''bio'' connotes
life. The dictionary definition of this combination form
denotes ''life or living organisms, or systems derived from
them.'' 4 This is an engineering-friendly definition, since it
incorporates systems. In fact, the discipline of ''biosystem
engineering'' relates to the ''operation on industrial scale
of biochemical processes . and is usually now termed
biochemical engineering.'' 5 Interestingly, this appears to
be a distinction between what molecular biologists and
biochemists do and what engineers do with the same in-
formation. Bioengineering is the ''application of the
physical sciences and engineering to the study of the
functioning of the human body and to the treatment and
correction of medical conditions.'' 6 This closely tracks
with the definition of ''biomedical engineering.''
Thus, engineers as agents of technological progress are
at a pivotal position. Technology will continue to play an
increasingly important role in the future. The concomi-
tant societal challenges require that every engineer fully
understands the implications and possible drawbacks of
these technological breakthroughs. Key among them will
be biotechnical advances at smaller scales, well below the
Table 8.2-1 Ranking by global health experts of top ten
biotechnologies needed to improve health in developing countries
Final ranking Biotechnology
1
Modified molecular technologies for affordable,
simple diagnosis of infectious diseases
2
Recombinant technologies to develop vaccines
against infectious diseases
3
Technologies for more efficient drug and vaccine
delivery systems
4
Technologies for environmental improvement
(sanitation, clean water, and bioremediation)
5
Sequencing pathogen genomes to understand their
biology and to identify new antimicrobials
6
Female-controlled protection against sexually
transmitted diseases, both with and without
contraceptive effect
7
Bioinformatics to identify drug targets and to
examine pathogen-host interactions
8
Genetically modified crops with increased
nutrients to counter specific deficiencies
9
Recombinant technology to make therapeutic
products (e.g., insulin, interferons) more affordable
10
Combinatorial chemistry for drug discovery
Source: Data from survey conducted in: A.S. Daar, H. Thorsteinsd ยด ttir, D.K.
Martin, A.C. Smith, S. Nast, and P.A. Singer, 2002, Top Ten Biotechnologies
for Improving Health in Developing Countries, Nature Genetics, 32, pp. 229-32.
cell and approaching the molecular level. Technological
processes at these scales require that engineers improve
their grasp of the potential ethical implications. The es-
sence of life processes is at stake.
Major bioethical areas
Engineering practice and research is deeply committed to
and involved in the advancing technologies that will
benefit humankind. However, this commitment and in-
volvement calls for deliberate and serious considerations
of actual and potential ethical issues. The President's
Council on Bioethics 7 has summarized the dichotomy
between the promise and the ethical challenges:
For roughly half a century, and at an ever-accelerating
pace, biomedical science has been gaining wondrous
new knowledge of the workings of living beings, from
small to great. Increasingly, it is providing precise and
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