Biomedical Engineering Reference
In-Depth Information
sciences and simultaneously take great care to ensure that
we are not opening some awful ''Pandora's box.''
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Finding this balance of acceptable and reasonable risk
goes beyond science, engineering, and technology and
enters the realms of ethics.
In a way, the advancement of science and its applica-
tions must follow a type of ethical index. Indices have
weighted values for each of the important variables.
Some more sophisticated indices have operators that can
shut the index down, such as a water quality index that
automatically goes to zero if certain levels of dissolved
oxygen are not available (even if all the other values are
fine). Thus, engineers need some type of working index
for biomedical ethics. They must be able to tell when
something is going awry. This is a tall order, since most of
us are well trained in the physical sciences and mathe-
matics, but few in the intricacies of biology associated
with health care. The exception, of course, is the bio-
medical engineer, but even their perspective of bio-
medicine varies from that of others in the health care
profession.
Choosing the right ''ethics index'' requires some
knowledge of the common ethical models used to eval-
uate engineering decisions and actions.
stage for ethical engineering. Ethicists sometimes refer
to goodness to be the result of ''right action.'' Virtue can
be defined as the power to do good or a habit of doing
good. In fact, one of Aristotle's most memorable lines is
''Excellence is habit.'' So, if we do good, we are more
likely, according to Aristotle, to keep doing good.
Conversely, vice is the power and the habit of doing
evil.
Truth
The subjectivity or relational nature of good and evil,
however, leads to some discomfort in scientific and en-
gineering circles, where meanings of certainty and con-
sistency of definition are crucial to problem solving.
Actually, this is consistent with the perspective of phi-
losophers, especially ethicists. Scientific facts are a cru-
cial part of any bioethical case analysis, and so are other
factors. To wit, philosophers tell us that we can de-
termine whether a moral argument is valid (not neces-
sarily correct) by parsing the argument into a ''syllogism,''
which consists of four parts:
1.
The factual premise
2.
The connecting premise (i.e., factual to evaluative)
3.
The evaluative premise
4.
The moral conclusion
For example, the facts may show that exposing people to
a chemical at a certain dosage (e.g., one part per million
or ppm) leads to a specific form of cancer in one in every
ten thousand people. We also know that, from a public
health perspective, allowing people to contract cancer as
a result of some human activity is morally wrong. Thus,
the syllogism would be the following:
Ethical theories: a primer
Engineers are more familiar with the works of Newton,
Boyle, Einstein, and Bohr than they are with those of
Hammarabi, Socrates, Hippocrates, Aristotle, Hobbes,
Mill, Kant and Rawls. However, it was only four cen-
turies ago that philosophy was central to all studies. In
fact, physical science was considered to be within the
realm of ''natural philosophy.'' The Ancient and Re-
naissance scientists did not distinguish ethics and other
aspects of philosophy from physics and other under-
pinning sciences of engineering. Later Descartes, Humes,
and Mill tried to turn things around by attempting to
place ethics under the scientific method. Although we
cannot return to such thinking completely, it may be
useful to consider our careers as engineers a bit more
comprehensively as a starting point for understanding
bioethics.
The comprehensive view allows us to consider some
topics not often covered in engineering texts; concepts
like good
versus
evil, moral
versus
immoral acts, and
obligations
versus
prohibitions are understood by most
professionals at some intuitive level, but unlike our
colleagues in the humanities and social sciences, we are
more likely to avoid considering them theoretically.
However, reading the classical works of Aristotle,
Aquinas, Kant,
et al
. makes the case for life being a mix
of virtues and vices available to humans. In fact, our
previous discussion about active engineering sets the
1.
Factual premise: exposure to chemical X at 1 ppm
leads to cancer
2.
Connecting premise: A company is releasing 10 kg of
chemical X per day which leads to 1 ppm exposure to
people living near an industrial plant
3.
Evaluative premise: decisions that allow industrial
releases that lead to cancer are morally wrong
4.
Moral conclusion: therefore, corporate executives
who decide to release 10 or more kilograms of
chemical X from their plants are morally wrong.
Science provides us with the factual premise and part of
the connecting premise, but social mores and norms
provide us with the evaluative premise and drive the
moral conclusion. However, if we are uncertain about the
facts, the validity of the argument is disrupted. Scientific
uncertainties are brought about both by variability and
error.
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Variability is ever present in space and time. Every
case has a unique set of factors, dependent variables,
